Healthcare Provider Details

I. General information

NPI: 1235937996
Provider Name (Legal Business Name): WING HEART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 PRUDENTIAL DR FL 1249
JACKSONVILLE FL
32207-8329
US

IV. Provider business mailing address

841 PRUDENTIAL DR FL 1249
JACKSONVILLE FL
32207-8329
US

V. Phone/Fax

Practice location:
  • Phone: 904-696-1888
  • Fax:
Mailing address:
  • Phone: 904-696-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: FALONE PIERRE LOUIS ARTY
Title or Position: OWNER
Credential:
Phone: 904-383-6654