Organization
HEARTLAND PEDIATRICS OF LAKE PLACID, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE THOMAS HREN (CEO)
(863) 676-1770
Entity
Organization
Contact information
Practice address
344 E ROYAL PALM ST, SUITE # 3, LAKE PLACID, FL 33852-5020
(863) 699-1414
(863) 699-9790
Mailing address
344 E ROYAL PALM ST, SUITE # 3, LAKE PLACID, FL 33852-5020
(863) 699-1414
(863) 699-9790
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
FL
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21799
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
05
—
253535100
—
FL
05
—
253535101
—
FL
Enumeration date
07/23/2006
Last updated
01/08/2025
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