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NPI Code Detail

MEDICARE: HEATHER WALTON PA-C

MEDICARE: HEATHER WALTON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician9117455FL
2363AS0400XSurgical Physician AssistantPA9117455FL

General Provider Information

NPI Number : 1063190551
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER WALTON PA-C
Provider Business Mailing Address
First Line : 4850 MILLENIA BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32839-6012
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4850 MILLENIA BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32839-6012
Country : US
Telephone Number : 407-264-5601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2023
Last Update Date : 08/31/2023

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Directions to “ HEATHER WALTON PA-C” Practice Location

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