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NPI Code Detail

MEDICARE: RICHARD MCCOY LDO

MEDICARE:   RICHARD  MCCOY  LDO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOpticianDO 1746FL

General Provider Information

NPI Number : 1578972378
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD MCCOY LDO
Provider Business Mailing Address
First Line : 1850 BOY SCOUT DR
Second Line : UNIT 107
City : FORT MYERS
State : FL
Zip : 33907-2127
Country : US
Telephone Number : 239-931-0136
Fax Number : 239-931-0910
Provider Business Practice Location Address
First Line : 1850 BOY SCOUT DR
Second Line : UNIT 107
City : FORT MYERS
State : FL
Zip : 33907-2127
Country : US
Telephone Number : 239-931-0136
Fax Number : 239-931-0910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2014
Last Update Date : 08/05/2014

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Directions to “ RICHARD MCCOY LDO” Practice Location

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