Individual
MS. CHANTEL RENE HEITLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6508 GUNN HIGHWAY, INDEPENDENT LIVING INC, TAMPA, FL 33625-4022
(813) 963-6923
(813) 264-0768
Mailing address
6508 GUNN HIGHWAY, INDEPENDENT LIVING INC, TAMPA, FL 33625-4022
(813) 963-6923
(813) 264-0768
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 9756
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10639001
CITRUS HMO
FL
01
—
355053
WELLCARE
FL
01
—
Y9817
BCBS
FL
Enumeration date
01/11/2007
Last updated
07/08/2007
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