MEDICARE: DR. CHARLES EDGAR COX MD, MPH, MMM

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	207Q00000X	Family Medicine Physician	ME62169	FL

General Provider Information

NPI Number	:	1164621850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES EDGAR COX MD, MPH, MMM

Provider Business Mailing Address
First Line	:	4200 W CYPRESS ST
Second Line	:	SUITE 1000
City	:	TAMPA
State	:	FL
Zip	:	33607-4156
Country	:	US
Telephone Number	:	813-830-6943
Fax Number	:	866-494-2927

Provider Business Practice Location Address
First Line	:	4200 W CYPRESS ST
Second Line	:	SUITE 1000
City	:	TAMPA
State	:	FL
Zip	:	33607-4156
Country	:	US
Telephone Number	:	813-830-6943
Fax Number	:	866-494-2927

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/13/2007

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