Provider Demographics
NPI:1306934849
Name:HEARTLAND WOMENS HEALTH CENTER P A
Entity type:Organization
Organization Name:HEARTLAND WOMENS HEALTH CENTER P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:OYOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-752-8181
Mailing Address - Street 1:PO BOX 2757
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32056-2757
Mailing Address - Country:US
Mailing Address - Phone:386-752-8181
Mailing Address - Fax:
Practice Address - Street 1:351 NE FRANKLIN ST
Practice Address - Street 2:SUITE 1125
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-3089
Practice Address - Country:US
Practice Address - Phone:386-752-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59691207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055227500Medicaid
FL12800OtherBCBS OF FL
214713OtherAVMED
P00162358OtherRAILROAD MEDICARE
E98997Medicare UPIN
FL12800OtherBCBS OF FL