MEDICARE: MYRON B COHEN DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN04275	FL

General Provider Information

NPI Number	:	1366535387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYRON B COHEN DDS PA

Provider Business Mailing Address
First Line	:	1518 W 49TH STREET
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2923
Country	:	US
Telephone Number	:	305-823-2661
Fax Number	:	305-823-2761

Provider Business Practice Location Address
First Line	:	1518 W 49TH STREET
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2923
Country	:	US
Telephone Number	:	305-823-2661
Fax Number	:	305-823-2761

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MYRON BENJAMIN COHEN
Credential	:	DDS
Telephone Number	:	305-823-2661

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/22/2020

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