Provider Demographics
NPI:1265427298
Name:COHEN, LEONARD VERNON (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:VERNON
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:PO BOX 160010
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-0001
Mailing Address - Country:US
Mailing Address - Phone:305-933-5993
Mailing Address - Fax:305-933-4135
Practice Address - Street 1:21000 NE 28TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1421
Practice Address - Country:US
Practice Address - Phone:305-933-5993
Practice Address - Fax:305-933-4135
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2021-03-24
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FLME00760302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256134400Medicaid
FLG81605Medicare UPIN