MEDICARE: HEIDI MARJAANA LAHTEENMAA DO

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
1	2084P0800X	Psychiatry Physician	OS16911	FL

General Provider Information

NPI Number	:	1770859845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI MARJAANA LAHTEENMAA DO

Provider Business Mailing Address
First Line	:	3540 S OCEAN BLVD APT 805
Second Line	:
City	:	SOUTH PALM BEACH
State	:	FL
Zip	:	33480-5779
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 S OCEAN BLVD APT 805
Second Line	:
City	:	SOUTH PALM BEACH
State	:	FL
Zip	:	33480-5779
Country	:	US
Telephone Number	:	702-755-6142
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	12/15/2022

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