MEDICARE: DR. MICHAEL I. COHEN I D.C.

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	111N00000X	Chiropractor	CH6614	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	589-7905	OTHER	FL	GHI
2	21195294748	OTHER	FL	BEECH STREET
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225041015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL I. COHEN I D.C.

Provider Business Mailing Address
First Line	:	2631 E OAKLAND PARK BLVD
Second Line	:	SUITE 104
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1657
Country	:	US
Telephone Number	:	954-537-5558
Fax Number	:	954-537-7997

Provider Business Practice Location Address
First Line	:	2631 E OAKLAND PARK BLVD
Second Line	:	SUITE 104
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1657
Country	:	US
Telephone Number	:	954-537-5558
Fax Number	:	954-537-7997

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	05/08/2008

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Directions to “ DR. MICHAEL I. COHEN I D.C.” Practice Location

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