MEDICARE: DOUGLAS H COHEN DPM

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	213E00000X	Podiatrist	PO2667	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480033658	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	629392	OTHER	FL	ANTHEM BCBS
4	149485	OTHER	FL	UMWA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770671323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS H COHEN DPM

Provider Business Mailing Address
First Line	:	2000 S OCEAN BLVD
Second Line	:	SUITE 12G
City	:	BOCA RATON
State	:	FL
Zip	:	33432-8535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8614 E STATE ROAD 70
Second Line	:	SUITE 200
City	:	BRADENTON
State	:	FL
Zip	:	34202-3710
Country	:	US
Telephone Number	:	941-408-5517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	10/03/2016

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Directions to “ DOUGLAS H COHEN DPM” Practice Location

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