Healthcare Provider Details

I. General information

NPI: 1003239872
Provider Name (Legal Business Name): THE MCCOY INSTITUTE OF HEARING AND BALANCE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 UNIVERSITY BLVD S
JACKSONVILLE FL
32216-8933
US

IV. Provider business mailing address

1922 UNIVERSITY BLVD S
JACKSONVILLE FL
32216-8933
US

V. Phone/Fax

Practice location:
  • Phone: 904-318-3763
  • Fax: 904-212-0665
Mailing address:
  • Phone: 904-318-3763
  • Fax: 904-212-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QV0200X
TaxonomyVA Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code291900000X
TaxonomyMilitary Clinical Medical Laboratory
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code292200000X
TaxonomyDental Laboratory
License Number
License Number State
# 10
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 11
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1758
License Number StateFL

VIII. Authorized Official

Name: DR. NATALLA S MCCOY
Title or Position: CLINICAL DIRECTOR
Credential: AU.D.
Phone: 904-864-8594