Provider Demographics
NPI:1245346865
Name:COHEN, PHILIP LOUIS (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:LOUIS
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 1:483 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3939
Mailing Address - Country:US
Mailing Address - Phone:407-628-0221
Mailing Address - Fax:407-628-4932
Practice Address - Street 1:483 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3939
Practice Address - Country:US
Practice Address - Phone:407-628-0221
Practice Address - Fax:407-628-4932
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 30560207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD64246Medicare UPIN