Provider Demographics
NPI:1518377639
Name:MCCOY, LEDEANNA (ARDMS)
Entity Type:Individual
Prefix:
First Name:LEDEANNA
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:ARDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 IVES DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2538
Mailing Address - Country:US
Mailing Address - Phone:305-801-3336
Mailing Address - Fax:305-651-5732
Practice Address - Street 1:1031 IVES DAIRY RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2538
Practice Address - Country:US
Practice Address - Phone:305-801-3336
Practice Address - Fax:305-651-5732
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL973072471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography