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General NPI Number Information
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NPI Number | 1306934849
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Entity Type | Organization
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Legal Business Name | HEARTLAND WOMENS HEALTH CENTER P A
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 351 NE FRANKLIN ST SUITE 1125
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City | LAKE CITY
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State | FL
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Zip | 32055-3089
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Country | US
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Telephone | 386-752-8181
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2757
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City | LAKE CITY
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State | FL
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Zip | 32056-2757
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Country | US
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Telephone | 386-752-8181
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FELIX DANIEL OYOLA
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Credential | M.D.
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Telephone | 386-752-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME59691
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License Number State | FL
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