# HEART OF FLORIDA DIABETES AND ENDOCRINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467772145
- **Authorized official:** DR. HIBA AL-DABAGH MD (PRESIDENT)
- **Authorized official phone:** (863) 419-7509

## Contact information

- **Practice address:** 171 WEBB DR, STE 2, DAVENPORT, FL 33837-3944
- **Practice address phone:** (863) 419-7509
- **Practice address fax:** (863) 419-7824
- **Mailing address:** 171 WEBB DR, STE 2, DAVENPORT, FL 33837-3944
- **Mailing address phone:** (863) 419-7509
- **Mailing address fax:** (863) 419-7824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2010
- **Last updated:** 06/04/2010