Heathrow Internal Medicine Llc

LBN: Heathrow Internal Medicine Llc
Heathrow Internal Medicine Llc is an health care organization with primary practice located at 4106 W Lake Mary Blvd Suite 100, Lake Mary FL 32746-3315. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Heathrow Internal Medicine Llc can be contacted via phone (407) 333-2273, or through Johnson, Tedrick via phone (407) 333-2273.

Contact Information

Primary practice address
4106 W Lake Mary Blvd Suite 100 Lake Mary FL 32746-3315
Phone: (407) 333-2273
Fax: (407) 333-3939
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Tedrick
Phone: (407) 333-2273

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1033387865
LBN Legal business name Heathrow Internal Medicine Llc
DBA Doing business as
Authorized official Johnson, Tedrick
Entity Organization
Organization subpart 1 No
Enumeration date Feb 14th, 2008
Last updated May 28th, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033387865 NPPES
Florida MEDICAID 000617400
Florida MEDICAID 307909100
Florida Other AM199
Florida Other PTAN DN9084

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