Provider Demographics
NPI:1093732786
Name:LIFELINK HEALTHCARE INSTITUTE INC
Entity Type:Organization
Organization Name:LIFELINK HEALTHCARE INSTITUTE INC
Other - Org Name:LIFELINK TRANSPLANT INSTITUTE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:HEINRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-251-8017
Mailing Address - Street 1:409 BAYSHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2707
Mailing Address - Country:US
Mailing Address - Phone:813-251-8017
Mailing Address - Fax:813-251-0096
Practice Address - Street 1:409 BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2707
Practice Address - Country:US
Practice Address - Phone:813-251-8017
Practice Address - Fax:813-251-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379087800Medicaid
W94795Medicare UPIN
FL33727Medicare PIN