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General NPI Number Information
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NPI Number | 1184047052
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Entity Type | Individual
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Provider Name | PENNY SUZANNE HEINZ LPTA,LMT,NASM-CPT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 01/29/2014
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Provider Practice Location Address
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Address Line | 1010 AMERICAN EAGLE BLVD
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5284
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Country | US
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Telephone | 813-634-1668
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Fax | 813-634-9578
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Provider Business Mailing Address
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Address Line | 1010 AMERICAN EAGLE BLVD
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5284
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Country | US
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Telephone | 813-634-1668
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Fax | 813-634-9578
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA15676
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA31177
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License Number State | FL
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