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General NPI Number Information
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NPI Number | 1912934266
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Entity Type | Organization
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Legal Business Name | HEARTLAND INTERNAL MEDICINE ASSOCIATES, P.A.
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4301 SUN N LAKE BLVD SUITE 103
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City | SEBRING
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State | FL
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Zip | 33872-2162
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Country | US
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Telephone | 863-385-8010
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Fax | 863-385-8144
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Provider Business Mailing Address
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Address Line | 4301 SUN N LAKE BLVD SUITE 103
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City | SEBRING
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State | FL
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Zip | 33872-2162
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Country | US
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Telephone | 863-385-8010
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Fax | 863-385-8144
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Authorized Official
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Title or Position | OWNER
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Name | JORGE F GONZALEZ
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Credential | M.D.
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Telephone | 863-385-8010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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