MEDICARE: MRS. JANICE PRICE HEIDEL ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	ARNP666182	FL

General Provider Information

NPI Number	:	1194073916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANICE PRICE HEIDEL ARNP

Provider Business Mailing Address
First Line	:	PO BOX 616788
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32861-6788
Country	:	US
Telephone Number	:	863-701-4256
Fax Number	:	407-770-0661

Provider Business Practice Location Address
First Line	:	6416 OLD WINTER GARDEN RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-1348
Country	:	US
Telephone Number	:	863-701-4256
Fax Number	:	407-770-0661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2012
Last Update Date	:	08/19/2013

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