Provider Demographics
NPI:1891738407
Name:HEIL, ELIZABETH P (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:P
Last Name:HEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 W STATE ROAD 434
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4984
Mailing Address - Country:US
Mailing Address - Phone:407-767-8555
Mailing Address - Fax:
Practice Address - Street 1:521 W STATE ROAD 434
Practice Address - Street 2:SUITE 302
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4984
Practice Address - Country:US
Practice Address - Phone:407-767-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43957207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E61775Medicare UPIN
FL30799XMedicare PIN