Provider Demographics
NPI:1770940546
Name:GASKINS, HEIDI JANE (MS)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:JANE
Last Name:GASKINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S ORANGE BLOSSOM TRL STE 261
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-3197
Mailing Address - Country:US
Mailing Address - Phone:407-270-6685
Mailing Address - Fax:407-870-6686
Practice Address - Street 1:750 S ORANGE BLOSSOM TRL STE 261
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3197
Practice Address - Country:US
Practice Address - Phone:407-270-6685
Practice Address - Fax:407-870-6686
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management