MEDICARE: DR. ALBERT 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	174400000X	Specialist	ME13200	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME 13200	OTHER	FL	FLORIDA LICENSE

General Provider Information

NPI Number	:	1659587855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT COHEN M.D

Provider Business Mailing Address
First Line	:	4923 W BAY WAY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-4803
Country	:	US
Telephone Number	:	813-286-8663
Fax Number	:

Provider Business Practice Location Address
First Line	:	4923 W BAY WAY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-4803
Country	:	US
Telephone Number	:	813-286-8663
Fax Number	:

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

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	04/05/2011

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