Provider Demographics
NPI:1457346827
Name:COX, SHAWN H (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:H
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 1:901 N LAKE DESTINY RD
Mailing Address - Street 2:STE 400
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4844
Mailing Address - Country:US
Mailing Address - Phone:407-200-2230
Mailing Address - Fax:407-200-1352
Practice Address - Street 1:901 N LAKE DESTINY RD
Practice Address - Street 2:STE 400
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4844
Practice Address - Country:US
Practice Address - Phone:407-200-2230
Practice Address - Fax:407-200-1352
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95062207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274891600Medicaid
FL274891600Medicaid