Healthcare Provider Details

I. General information

NPI: 1073430419
Provider Name (Legal Business Name): GINA MARIE HEINTSKILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 WINTER GARDEN VINELAND RD
WINTER GARDEN FL
34787-9502
US

IV. Provider business mailing address

4040 WINTER GARDEN VINELAND RD
WINTER GARDEN FL
34787-9502
US

V. Phone/Fax

Practice location:
  • Phone: 407-573-3361
  • Fax:
Mailing address:
  • Phone: 407-573-3361
  • Fax: 407-395-8309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44790
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPTT44790
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: