Provider Demographics
NPI:1881996247
Name:CATHERINE COZAD, M.D., P.A.
Entity type:Organization
Organization Name:CATHERINE COZAD, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:COZAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-581-1121
Mailing Address - Street 1:8787 BRYAN DAIRY RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1251
Mailing Address - Country:US
Mailing Address - Phone:727-581-1121
Mailing Address - Fax:727-585-7357
Practice Address - Street 1:8787 BRYAN DAIRY RD
Practice Address - Street 2:SUITE 250
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1251
Practice Address - Country:US
Practice Address - Phone:727-581-1121
Practice Address - Fax:727-585-7357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53488207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048329000Medicaid
FL07669OtherBLUE CROSS BLUE SHIELD
FL048329000Medicaid