Provider Demographics
NPI:1326492927
Name:HEART HEALTH MANAGEMENT, LLC
Entity Type:Organization
Organization Name:HEART HEALTH MANAGEMENT, LLC
Other - Org Name:HEART HEALTH & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORINTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBLACK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:407-579-9589
Mailing Address - Street 1:2426 MARLEY CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-9132
Mailing Address - Country:US
Mailing Address - Phone:407-579-9589
Mailing Address - Fax:407-757-0128
Practice Address - Street 1:9753 S ORANGE BLOSSOM TRL STE 106
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8998
Practice Address - Country:US
Practice Address - Phone:407-745-4414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2747962251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care