Provider Demographics
NPI:1952939977
Name:VERMILYEA, HEATHER GEORGINA (DO)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GEORGINA
Last Name:VERMILYEA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3493
Mailing Address - Country:US
Mailing Address - Phone:813-596-9326
Mailing Address - Fax:813-894-7001
Practice Address - Street 1:12400 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3493
Practice Address - Country:US
Practice Address - Phone:813-596-9326
Practice Address - Fax:813-894-7001
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19886207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine