Heartland Pediatrics Of Lake Wales, P.A.
LBN: Heartland Pediatrics Of Lake Wales, L.L.C.,
Heartland Pediatrics Of Lake Wales, P.A. is an health care organization with primary practice located at 1354 State Road 60 E , Lake Wales FL 33853-4322. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Rural Health. Allopathic & Osteopathic Physicians / Pediatrics is the primary health care specialty.
Heartland Pediatrics Of Lake Wales, L.L.C., can be contacted via phone (863) 679-8888, or through Sonni, Rajeswari via phone (863) 679-8888.
Contact Information
Primary practice address
1354 State Road 60 E
Lake Wales FL 33853-4322
Phone: (863) 679-8888
Fax: (863) 676-2851
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X |
Profile Details
| NPI number | 1104989680 |
|---|---|
| LBN Legal business name | Heartland Pediatrics Of Lake Wales, L.L.C., |
| DBA Doing business as | Heartland Pediatrics Of Lake Wales, P.A. |
| Authorized official | Sonni, Rajeswari Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Sep 4th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104989680 | NPPES |
| Florida | Other | 21247 | BLUE CROSS BLUE SHIELD |
| Florida | MEDICAID | 251469900 | BLUE CROSS BLUE SHIELD |
| Florida | MEDICAID | 251469901 | BLUE CROSS BLUE SHIELD |
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