Provider Demographics
NPI:1578558995
Name:HEALY, DEVIN S (MED, ATC/L)
Entity Type:Individual
Prefix:MR
First Name:DEVIN
Middle Name:S
Last Name:HEALY
Suffix:
Gender:M
Credentials:MED, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 LONG LAKE CIR
Mailing Address - Street 2:APT 107
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-9604
Mailing Address - Country:US
Mailing Address - Phone:863-370-1809
Mailing Address - Fax:
Practice Address - Street 1:5150 LONG LAKE CIR
Practice Address - Street 2:APT 107
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-9604
Practice Address - Country:US
Practice Address - Phone:863-370-1809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist