Provider Demographics
NPI:1740679240
Name:MCCOY, LAQUITTA (APRN)
Entity type:Individual
Prefix:
First Name:LAQUITTA
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 972853
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33197-2853
Mailing Address - Country:US
Mailing Address - Phone:786-217-2892
Mailing Address - Fax:
Practice Address - Street 1:320 1ST ST S
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3501
Practice Address - Country:US
Practice Address - Phone:863-875-9351
Practice Address - Fax:863-247-8284
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9267395163W00000X
FL11000618363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse