Healthcare Provider Details

I. General information

NPI: 1023690666
Provider Name (Legal Business Name): AUSTIN EVANNE COYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 235
ORLANDO FL
32804-4659
US

IV. Provider business mailing address

333 SOUTH COLUMBIA STREET 126 MACNIDER HALL CB 7005
CHAPEL HILL NC
27599-7005
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7270
  • Fax: 407-303-2553
Mailing address:
  • Phone: 919-966-1043
  • Fax: 919-843-2356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME166462
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number303200
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: