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Organization
HEATHROW INTERNAL MEDICINE LLC
Active
Organization
HEATHROW INTERNAL MEDICINE LLC
Active
Parent organization
HEATHROW INTERNAL MEDICINE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEATHROW INTERNAL MEDICINE LLC
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(615) 372-3375
Entity
Organization
Contact information
Practice address
339 CYPRESS PKWY STE 210, KISSIMMEE, FL 34759-3315
(407) 502-2300
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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