MEDICARE: ROSS A. COHEN M.D.

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	208800000X	Urology Physician	ME0056876	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	340003666	OTHER	FL	RR MEDICARE
11	P01604779	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	206497	OTHER	FL	AVMED
2	3431	OTHER	FL	DIMENSION
3	09628	OTHER	FL	BC/BS FLORIDA
5	1193668	OTHER	FL	CIGNA
6	P971746	OTHER	FL	OPTIMUM
7	P00337	OTHER	FL	FREEDOM
8	09628	OTHER	FL	BCBS
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	4116931	OTHER	FL	AETNA
12	06798	OTHER	FL	WELLCARE
13	1010101	OTHER	FL	WELLCARE
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639171986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSS A. COHEN M.D.

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: PAYER CONTRACTING & RELATIONS DEPT.
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	5065 STATE ROAD 17
Second Line	:	SUITE 203
City	:	LAKE WORTH
State	:	FL
Zip	:	33449-4615
Country	:	US
Telephone Number	:	561-432-0067
Fax Number	:	561-432-0066

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	11/10/2016

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Directions to “ ROSS A. COHEN M.D.” Practice Location

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