Provider Demographics
NPI:1508944927
Name:COHEN, LEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:LEVI
Middle Name:
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 1:16158 S. MILITARY TRAIL
Mailing Address - Street 2:
Mailing Address - City:DELRAY BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33484
Mailing Address - Country:US
Mailing Address - Phone:561-637-7425
Mailing Address - Fax:561-637-7481
Practice Address - Street 1:16158 S. MILITARY TRAIL
Practice Address - Street 2:
Practice Address - City:DELRAY BCH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:561-637-7425
Practice Address - Fax:561-637-7481
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139422084P0800X, 2084P0802X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51727OtherUNITEDBEHAVIORALHEALTH
FL30786OtherBLUECROSSBLUESHIELDFL
FL420022500Medicaid
FL420022500Medicaid
FL30786BMedicare ID - Type Unspecified
FLD54127Medicare UPIN