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NPI Code Detail

MEDICARE: DR. RENEE HEINTZ

MEDICARE: DR. RENEE HEINTZ
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
1183500000XPharmacistPS43214FL
2183500000XPharmacist19349NC

General Provider Information

NPI Number : 1255679825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENEE HEINTZ
Provider Business Mailing Address
First Line : 1075 PASADENA AVE S
Second Line :
City : SOUTH PASADENA
State : FL
Zip : 33707-2037
Country : US
Telephone Number : 727-347-4526
Fax Number : 727-347-4019
Provider Business Practice Location Address
First Line : 1075 PASADENA AVE S
Second Line :
City : SOUTH PASADENA
State : FL
Zip : 33707-2037
Country : US
Telephone Number : 727-347-4526
Fax Number : 727-347-4019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2013
Last Update Date : 01/16/2013

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