Individual
HEATHER LEA NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13201 WALSINGHAM RD STE 200, LARGO, FL 33774
(727) 261-1754
Mailing address
13201 WALSINGHAM RD STE 200, LARGO, FL 33774-3515
(727) 261-1754
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102254
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291532400
—
FL
01
—
P00080046
RAILROAD MEDICARE
—
Enumeration date
04/06/2006
Last updated
10/03/2019
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