Provider Demographics
NPI:1659671774
Name:HEART OF THE VILLAGES PLC
Entity Type:Organization
Organization Name:HEART OF THE VILLAGES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORG
Authorized Official - Middle Name:J
Authorized Official - Last Name:COUTURIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-674-2080
Mailing Address - Street 1:1149 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159
Mailing Address - Country:US
Mailing Address - Phone:352-674-2080
Mailing Address - Fax:352-674-2177
Practice Address - Street 1:1149 MAIN STREET
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-674-2080
Practice Address - Fax:352-674-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94811207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty