HEATHROW INTERNAL MEDICINE LLC


Address: 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3315
Phone: 4073332273

HEATHROW INTERNAL MEDICINE LLC (NPI# 1033387865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033387865
Entity Type Organization
Organization Name HEATHROW INTERNAL MEDICINE LLC
Practice Address 4106 W Lake Mary Blvd
Suite 100
Lake Mary
FL 32746-3315
Practice Telephone 4073332273
Practice Fax Number 4073333939
Mailing Telephone 4073332273
Mailing Fax Number 4073333939
Enumeration Date 2008-02-14
Last Update Date 2014-05-28
Authorized Official Name MR. TEDRICK JOHNSON (GROUP VP OPERATIONS)
Authorized Official Telephone 4073332273
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine Allopathic & Osteopathic Physicians
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 307909100 05
FL MEDICARE PTAN AM199 01
FL MEDICARE RAILROAD PTAN DN9084 01
FL 000617400 05

Office Location

Street Address 4106 W LAKE MARY BLVD
SUITE 100
City LAKE MARY
State FL
Zip Code 32746-3315

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710979554 Christopher C Mason Podiatrist 4106 W Lake Mary Blvd, 125, Lake Mary, FL 32746-3315 2005-08-18
1609346378 Nicole Rodriguez Nurse Practitioner 4106 W Lake Mary Blvd, Lake Mary, FL 32746-3315 2018-11-26
1659681575 Vikram P Mehta Md Pa Surgery 4106 W Lake Mary Blvd, Suite 224, Lake Mary, FL 32746-3315 2010-10-13
1194044107 Christopher C. Mason, D.p.m., Pa Durable Medical Equipment & Medical Supplies 4106 W Lake Mary Blvd, Suite 125, Lake Mary, FL 32746-3315 2010-06-01
1063651131 Nathan Christopher Deangelis Surgery 4106 W Lake Mary Blvd, Suite 330, Lake Mary, FL 32746-3315 2009-02-13
1487801957 Creighton D Fiscina Surgery 4106 W Lake Mary Blvd, Suite 330, Lake Mary, FL 32746-3315 2008-08-26
1043480700 Vein Help of Orlando Phlebology 4106 W Lake Mary Blvd, Ste 324, Lake Mary, FL 32746-3315 2008-03-09
1396921995 Vein Associates, P.a. Phlebology 4106 W Lake Mary Blvd, Suite 325, Lake Mary, FL 32746-3315 2008-01-14
1780870071 Robin Rahm Md Pa Surgery 4106 W Lake Mary Blvd, Suite 213, Lake Mary, FL 32746-3315 2007-09-20
1740499128 Family Medicine On Call, Inc Family Medicine 4106 W Lake Mary Blvd, Suite 110, Lake Mary, FL 32746-3315 2007-05-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588286397 James Maggert Physical Therapist Sst Rehab, 635 Century Pt - Suite 111, Lake Mary, FL 32746 2020-05-14
1225663743 Jamie Pecot Behavior Technician 300 International Parkway, 200, Lake Mary, FL 32746 2020-03-04
1619509585 Dental Associates of Heathrow, LLC Dentist Dental Associates of Heathrow, LLC, 120 International Parkway Suite 26, Heathrow, FL 32746 2020-02-10
1376185876 Rinehart Road Surgery Center, LLC Clinic/Center 392 Rinehart Road, Suite 1100, Lake Mary, FL 32746 2019-10-16
1871140988 Central Florida Wellness LLC General Practice 1061 S Sun Drove, Suite 1041, Lake. Mary, FL 32746 2019-08-22
1326609942 Antoine Slade I Behavior Technician 4876 Rhinehart Road, Lake Mary, FL 32746 2019-06-25
1245891209 Ohri, LLC Clinic/Center 392 Rinehart Rd., Suite 1300, Lake Mary, FL 32746 2019-06-21
1336610856 Olivia Laurel Stolz Physician Assistant 3300 West Lake Mary Blvd, 220, Lake Mary, FL 32746 2018-12-10
1881171072 Elite-star Medical Transport LLC. Non-emergency Medical Transport (VAN) 2910 W Lake Mary Blvd Ste 101, Lake Mary, FL 32746 2018-07-20
1508351537 Ariagny Elena Fereira Speech-Language Pathologist 145 Middle Street Suite 1101, Lake Mary, FL 32746 2018-06-22
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245729862 Adventist Health System/sunbelt, Inc. Family Medicine 2948 West Lake Mary Blvd, Lake Mary, FL 32746 2018-05-09
1245616192 Central Parc Wellness Family Medicine 920 International Pkwy, Suite # 1056, Lake Mary, FL 32746-5219 2015-08-03
1598053654 Hina Khan Durani Family Medicine 4106 W Lake Mary Blvd Ste 4106, Lake Mary, FL 32746-3315 2011-07-11
1437451887 Lake Mary Medical Center Family Medicine 3629 Lake Emma Rd, Lake Mary, FL 32746-6199 2010-11-17
1245530575 Physicians Home Visits LLC Family Medicine 3624 Simonton Pl, Lake Mary, FL 32746-6741 2010-11-03
1477870160 Roman Medical LLC Family Medicine 460 Raccoon St, Lake Mary, FL 32746-3802 2010-04-21
1457504540 Robert E Sutton Family Medicine 1561 Langham Ter, Lake Mary, FL 32746-1970 2008-11-03
1801045760 Mukti Pillappa Family Medicine 707 Platinum Pt, Lake Mary, FL 32746-5702 2008-09-16
1578724183 Moore Medical Group Inc Family Medicine 4300 W Lake Mary Blvd, Ste 1010-357, Lake Mary, FL 32746-2060 2008-06-17
1174781710 Juveria Tawwab Family Medicine 2605 W Lake Mary Blvd, #119, Lake Mary, FL 32746-3568 2008-05-30
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Competitor

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City LAKE MARY
Zip Code 32746

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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