Provider Demographics
NPI:1174529234
Name:COHEN, STEVEN MYLES (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MYLES
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 1:579 S DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-6256
Mailing Address - Country:US
Mailing Address - Phone:727-445-9110
Mailing Address - Fax:727-466-0306
Practice Address - Street 1:579 S DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-6256
Practice Address - Country:US
Practice Address - Phone:727-445-9110
Practice Address - Fax:727-466-0306
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65445207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262827900Medicaid
FLP00229506OtherRAILROAD MEDICARE
FL25418SMedicare PIN
FL25418Medicare PIN
FL25418TMedicare PIN
FLP00229506OtherRAILROAD MEDICARE
FLF10746Medicare UPIN
FL25418VMedicare PIN