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NPI Code Detail

MEDICARE: HEATHER DENISE CONYERS

MEDICARE: HEATHER DENISE CONYERS
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
1372600000XAdult CompanionFL

General Provider Information

NPI Number : 1245841311
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER DENISE CONYERS
Provider Business Mailing Address
First Line : 401 E JACKSON ST STE 2340
Second Line :
City : TAMPA
State : FL
Zip : 33602-5226
Country : US
Telephone Number : 813-796-5113
Fax Number : 813-796-5108
Provider Business Practice Location Address
First Line : 401 E JACKSON ST STE 2340
Second Line :
City : TAMPA
State : FL
Zip : 33602-5226
Country : US
Telephone Number : 813-796-5113
Fax Number : 813-796-5108
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2020
Last Update Date : 10/05/2021

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Directions to “ HEATHER DENISE CONYERS ” Practice Location

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