Healthcare Provider Details

I. General information

NPI: 1962789081
Provider Name (Legal Business Name): RITA COYNE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date: 09/26/2014
Reactivation Date: 11/06/2024

III. Provider practice location address

2479 ALOMA AVE
WINTER PARK FL
32792-2541
US

IV. Provider business mailing address

520 FERNWOOD DR
ALTAMONTE SPRINGS FL
32701-6336
US

V. Phone/Fax

Practice location:
  • Phone: 407-898-7798
  • Fax:
Mailing address:
  • Phone: 407-961-9283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: