Healthcare Provider Details

I. General information

NPI: 1528130549
Provider Name (Legal Business Name): ALVIN COHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE SUITE 445
HOLLYWOOD FL
33021-5424
US

IV. Provider business mailing address

1150 N 35TH AVE SUITE 445
HOLLYWOOD FL
33021-5424
US

V. Phone/Fax

Practice location:
  • Phone: 954-961-7771
  • Fax: 954-961-9633
Mailing address:
  • Phone: 954-961-7771
  • Fax: 954-961-9633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME12862
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: