Provider Demographics
NPI:1962020917
Name:COX, ANNA MARIE (LDO)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:MARIE
Last Name:COX
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 MAITLAND CENTER PKWY STE 162
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4162
Mailing Address - Country:US
Mailing Address - Phone:419-279-9862
Mailing Address - Fax:
Practice Address - Street 1:2600 MAITLAND CENTER PKWY STE 162
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4162
Practice Address - Country:US
Practice Address - Phone:419-279-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5482156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDO5462OtherSTATE OF FLORIDA DIVISION OF MEDICAL QUALITY ASSURANCE