Provider Demographics
NPI:1780631796
Name:COHEN, ROBERT E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:COHEN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 W GORE ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1114
Mailing Address - Country:US
Mailing Address - Phone:321-841-2452
Mailing Address - Fax:407-841-4076
Practice Address - Street 1:32 W GORE ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1114
Practice Address - Country:US
Practice Address - Phone:321-841-2452
Practice Address - Fax:407-841-4076
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7151103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY7151OtherMEDICAL LICENSE
FLU8034ZMedicare PIN
FLU8034XMedicare PIN
FLU8034YMedicare PIN