Provider Demographics
NPI:1528130549
Name:COHEN, ALVIN (MD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N 35TH AVE
Mailing Address - Street 2:SUITE 445
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5424
Mailing Address - Country:US
Mailing Address - Phone:954-961-7771
Mailing Address - Fax:954-961-9633
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE 445
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-961-7771
Practice Address - Fax:954-961-9633
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME12862207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD61437Medicare UPIN
FL06832Medicare ID - Type Unspecified