Provider Demographics
NPI:1003239872
Name:THE MCCOY INSTITUTE OF HEARING AND BALANCE,LLC
Entity Type:Organization
Organization Name:THE MCCOY INSTITUTE OF HEARING AND BALANCE,LLC
Other - Org Name:MCCOY INSTITUTE OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:904-864-8594
Mailing Address - Street 1:1922 UNIVERSITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8933
Mailing Address - Country:US
Mailing Address - Phone:904-318-3763
Mailing Address - Fax:904-212-0665
Practice Address - Street 1:1922 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8933
Practice Address - Country:US
Practice Address - Phone:904-318-3763
Practice Address - Fax:904-212-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X, 261QD0000X, 261QH0100X, 261QH0700X, 261QM0850X, 261QV0200X, 291900000X, 291U00000X, 292200000X, 332S00000X
FLAY1758231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No171000000XOther Service ProvidersMilitary Health Care ProviderGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
No291900000XLaboratoriesMilitary Clinical Medical Laboratory
No291U00000XLaboratoriesClinical Medical Laboratory
No292200000XLaboratoriesDental Laboratory
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty