MEDICARE: DR. MICHAEL MENASHE 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	P0001763	FL
2	213E00000X	Podiatrist	E3281	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	65099	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1568457588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL MENASHE COHEN DPM

Provider Business Mailing Address
First Line	:	1725 N UNIVERSITY DR
Second Line	:	STE 302
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6089
Country	:	US
Telephone Number	:	954-245-5223
Fax Number	:	954-345-9985

Provider Business Practice Location Address
First Line	:	1725 UNIVERSITY DR
Second Line	:	STE 302
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6089
Country	:	US
Telephone Number	:	954-245-5223
Fax Number	:	954-345-9985

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	02/14/2008

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