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General NPI Number Information
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NPI Number | 1154957991
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Entity Type | Individual
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Provider Name | SHARON LYNN HEANEY
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Gender | Female
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Dates
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Enumeration Date | 03/12/2020
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 415 DAVID ST
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-2609
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Country | US
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Telephone | 407-529-4280
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Fax |
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Provider Business Mailing Address
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Address Line | 732 FANNING DR
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-6515
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Country | US
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Telephone | 407-529-4280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL13410
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License Number State | FL
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