Provider Demographics
NPI:1790072312
Name:DANIEL D. COHEN MD PA
Entity Type:Organization
Organization Name:DANIEL D. COHEN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:COHEN-NEAMIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-622-2030
Mailing Address - Street 1:PO BOX 940459
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-0459
Mailing Address - Country:US
Mailing Address - Phone:407-622-2030
Mailing Address - Fax:407-622-2033
Practice Address - Street 1:315 N LAKEMONT AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3205
Practice Address - Country:US
Practice Address - Phone:407-622-2030
Practice Address - Fax:407-622-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-04
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFE736AMedicare PIN