The city was founded in 1835 when several families moved to Roatán from the Cayman Islands. It is named after pirate Captain John Coxen/Coxon. Roatán was once home to over 5,000 pirates.
Bus service connects Coxen Hole with other points on the island. Coxen Hole Stadium is located in the town. There is also a small hospital, Woods Medical Facility.
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