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Organization
HEARTLAND SURGICAL ASSISTANTS, INC
Active
Organization
HEARTLAND SURGICAL ASSISTANTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN K CARLISLE PAC (PRESIDENT)
(863) 381-7632
Entity
Organization
Contact information
Practice address
200 AVENUE F NE, WINTER HAVEN, FL 33881-4131
(863) 381-7647
Mailing address
5112 LAKE DEESON WOODS CT, LAKELAND, FL 33805-7638
(863) 381-7632
(863) 606-5713
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1682
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA4132
RAILROAD MEDICARE
FL
01
—
X1592
BCBS
FL
Enumeration date
10/13/2006
Last updated
07/21/2022
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