Healthcare Provider Details

I. General information

NPI: 1164875894
Provider Name (Legal Business Name): SCOTT R HEILMANN ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12216 PANAMA CITY BEACH PKWY STE C
PANAMA CITY BEACH FL
32407-2728
US

IV. Provider business mailing address

12216 PANAMA CITY BEACH PKWY STE C
PANAMA CITY BEACH FL
32407-2728
US

V. Phone/Fax

Practice location:
  • Phone: 850-775-0121
  • Fax: 850-999-7116
Mailing address:
  • Phone: 850-775-0121
  • Fax: 850-999-7116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9335171
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: