Healthcare Provider Details

I. General information

NPI: 1215376645
Provider Name (Legal Business Name): CHRISTINA MARSALISI MCCOY D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 66TH ST N
ST PETERSBURG FL
33710-8747
US

IV. Provider business mailing address

1800 66TH ST N
ST PETERSBURG FL
33710-8747
US

V. Phone/Fax

Practice location:
  • Phone: 727-893-6323
  • Fax: 727-893-6234
Mailing address:
  • Phone: 727-893-6323
  • Fax: 727-893-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS13340
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: