Provider Demographics
NPI:1902414253
Name:PALONIS, HEATHER M (CPBT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:PALONIS
Suffix:
Gender:F
Credentials:CPBT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:335 MORAY DR SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-6423
Mailing Address - Country:US
Mailing Address - Phone:321-522-7466
Mailing Address - Fax:321-989-0226
Practice Address - Street 1:335 MORAY DR SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-6423
Practice Address - Country:US
Practice Address - Phone:321-522-7466
Practice Address - Fax:321-989-0226
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty