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General NPI Number Information
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NPI Number | 1942605688
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Entity Type | Individual
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Provider Name | LAVONIA VALERIE MCCOY
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Gender | Female
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 2981 NW 164TH TER
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City | MIAMI GARDENS
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State | FL
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Zip | 33054-6433
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Country | US
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Telephone | 305-310-7212
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Fax | 786-373-3340
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Provider Business Mailing Address
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Address Line | 2981 NW 164TH TER
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City | MIAMI GARDENS
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State | FL
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Zip | 33054-6433
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Country | US
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Telephone | 305-310-7212
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Fax | 789-373-3340
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 5164644
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9533773
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License Number State | FL
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