Provider Demographics
NPI:1255532289
Name:MCCOY, CATHRINE LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CATHRINE
Middle Name:LYNN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7179 WINDING LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5663
Mailing Address - Country:US
Mailing Address - Phone:407-971-1791
Mailing Address - Fax:407-303-4305
Practice Address - Street 1:1215 E LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5401
Practice Address - Country:US
Practice Address - Phone:321-800-5946
Practice Address - Fax:407-896-2700
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL239102OtherNABP E-PROFILE