MEDICARE: DR. CATHERINE LOUISE COZAD 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	207VG0400X	Gynecology Physician	ME53488	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	160055408	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1319	OTHER	HUMANA
3	5950034	OTHER	AETNA
4	07669	OTHER	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1154317592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE LOUISE COZAD M.D.

Provider Business Mailing Address
First Line	:	8787 BRYAN DAIRY RD
Second Line	:	SUITE 250
City	:	LARGO
State	:	FL
Zip	:	33777-1251
Country	:	US
Telephone Number	:	727-518-1121
Fax Number	:	727-585-7357

Provider Business Practice Location Address
First Line	:	8787 BRYAN DAIRY RD
Second Line	:	SUITE 250
City	:	LARGO
State	:	FL
Zip	:	33777-1251
Country	:	US
Telephone Number	:	727-518-1121
Fax Number	:	727-585-7357

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	07/29/2010

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Directions to “ DR. CATHERINE LOUISE COZAD M.D.” Practice Location

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