Provider Demographics
NPI:1477533370
Name:COHEN, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 W MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4453
Mailing Address - Country:US
Mailing Address - Phone:407-648-4323
Mailing Address - Fax:407-839-1493
Practice Address - Street 1:80 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4453
Practice Address - Country:US
Practice Address - Phone:407-648-4323
Practice Address - Fax:407-839-1493
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00484372086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL059581100Medicaid
FL4008324OtherAETNA PPO ID NUMBER
FL230000341OtherRAILROAD MEDICARE
FL339360OtherUNITED ID NUMBER
FL0007911OtherAETNA HMO ID NUMBER
FL5795620OtherGHI ID NUMBER
FL05236OtherWELLCARE ID NUMBER
FL47803XOtherBC/BS OF FLORIDA
FL1791685OtherCIGNA ID NUMBER
FL209960OtherAV-MED ID NUMBER
FL1791685OtherCIGNA ID NUMBER
FL209960OtherAV-MED ID NUMBER
FL230000341OtherRAILROAD MEDICARE