Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 21533 | FL |
Y | 2251N0400X | Physical Therapist - Neurology | PT21533 | FL |
NPI | 1508382821 |
---|---|
Provider Name | Mrs. Christina Mccoy |
First Address | Winter Garden, FL 34787-5269 |
Second Address | Celebration, FL 34747-4970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2017 |
Last Update Date | 17/08/2017 |