Provider Demographics
NPI:1164621850
Name:COX, CHARLES EDGAR (MD, MPH, MMM)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EDGAR
Last Name:COX
Suffix:
Gender:M
Credentials:MD, MPH, MMM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 W CYPRESS ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-4156
Mailing Address - Country:US
Mailing Address - Phone:813-830-6943
Mailing Address - Fax:866-494-2927
Practice Address - Street 1:4200 W CYPRESS ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4156
Practice Address - Country:US
Practice Address - Phone:813-830-6943
Practice Address - Fax:866-494-2927
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62169207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine