Organization
HEARTLAND NEUROLOGY, PLLC
Active
Organization
HEARTLAND NEUROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY CARRINGTON GOULD JR. (OFFICE MANAGER)
(239) 542-0939
Entity
Organization
Contact information
Practice address
777 W HICKPOCHEE AVE UNIT C, LABELLE, FL 33935-4330
(863) 230-6950
(208) 275-0119
Mailing address
777 W HICKPOCHEE AVE UNIT C, LABELLE, FL 33935-4330
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
ME117089
FL
2084N0400X
Neurology Physician
Primary
ME117089
FL
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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