Healthcare Provider Details
I. General information
NPI: 1598751216
Provider Name (Legal Business Name): OSTEOPATHIC HERITAGE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2005
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 SEVEN HILLS DR
SPRING HILL FL
34609-0235
US
IV. Provider business mailing address
118 SEVEN HILLS DR
SPRING HILL FL
34609-0235
US
V. Phone/Fax
- Phone: 352-666-6950
- Fax: 352-666-6438
- Phone: 352-666-6950
- Fax: 352-666-6438
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | OS6098 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name:
JEFFREY
S.
GROVE
Title or Position: PHYSICIAN/OWNER
Credential: D.O.
Phone: 352-666-6950