Healthcare Provider Details

I. General information

NPI: 1922109495
Provider Name (Legal Business Name): HEIDI ANN PICCIONE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11375 BIG BEND RD
RIVERVIEW FL
33579-7183
US

IV. Provider business mailing address

11375 BIG BEND RD
RIVERVIEW FL
33579-7183
US

V. Phone/Fax

Practice location:
  • Phone: 813-805-8167
  • Fax: 844-214-1382
Mailing address:
  • Phone: 813-805-8167
  • Fax: 844-214-1382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT19670
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: