=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861399552
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARTLAND HEALTH INTEGRATED CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2026
-----------------------------------------------------
Last Update Date | 10/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 406 S DEANE DUFF AVE
-----------------------------------------------------
City | CLEWISTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33440-3818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-983-5453
-----------------------------------------------------
Fax | 863-983-2059
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 406 S DEANE DUFF AVE
-----------------------------------------------------
City | CLEWISTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33440-3818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-983-5453
-----------------------------------------------------
Fax | 863-983-2059
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | LUCY ELVEUS
-----------------------------------------------------
Credential | ARNP
-----------------------------------------------------
Telephone | 863-983-5453
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------