Provider Demographics
NPI:1982084653
Name:HEINTZ, ASHLEY (AP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HEINTZ
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15029 ARBOR RESERVE CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-5815
Mailing Address - Country:US
Mailing Address - Phone:813-505-0418
Mailing Address - Fax:
Practice Address - Street 1:15029 ARBOR RESERVE CIR APT 201
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-5815
Practice Address - Country:US
Practice Address - Phone:813-505-0418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3485171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist