Provider Demographics
NPI:1760786875
Name:COX, CECIL DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:CECIL
Middle Name:DOUGLAS
Last Name:COX
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 1:317 W MIRACLE STRIP PKWY
Mailing Address - Street 2:
Mailing Address - City:MARY ESHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1833
Mailing Address - Country:US
Mailing Address - Phone:850-244-3277
Mailing Address - Fax:
Practice Address - Street 1:317 W MIRACLE STRIP PKWY
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1833
Practice Address - Country:US
Practice Address - Phone:850-244-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME15771207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME15771OtherSTATE OF FLORIDA BOARD OF MEDICAL EXAMINERS