MEDICARE: TATIANA COX PSYD

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	103T00000X	Psychologist	12449	FL
2	103TC0700X	Clinical Psychologist	0006643	CO
3	103T00000X	Psychologist	0006643	CO
4	103TC0700X	Clinical Psychologist	12449	FL

General Provider Information

NPI Number	:	1740796333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATIANA COX PSYD

Provider Business Mailing Address
First Line	:	969 EMERALD GREEN CT
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-6150
Country	:	US
Telephone Number	:	305-850-7318
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 WILLET PL APT 1422
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32940-3611
Country	:	US
Telephone Number	:	407-615-9837
Fax Number	:

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

Provider Enumeration Date	:	12/19/2017
Last Update Date	:	12/09/2025

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Directions to “ TATIANA COX PSYD” Practice Location

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