Provider Demographics
NPI:1740260033
Name:MCCOY, DONALD L JR (DO)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:MCCOY
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:321-332-6947
Mailing Address - Fax:407-286-4515
Practice Address - Street 1:130 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2404
Practice Address - Country:US
Practice Address - Phone:352-528-5801
Practice Address - Fax:352-528-6019
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005395207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80116OtherBCBS
FL049437203Medicaid
FLE72671Medicare UPIN
FL80116DMedicare ID - Type UnspecifiedMEDICARE