Provider Demographics
NPI:1992965701
Name:CARPENTER, HEATHER L (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:CARPENTER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4881 NW 8TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-224-2485
Mailing Address - Fax:352-224-2476
Practice Address - Street 1:4343 W NEWBERRY RD STE 5
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2824
Practice Address - Country:US
Practice Address - Phone:352-224-2200
Practice Address - Fax:352-224-2476
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2014-07-17
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Provider Licenses
StateLicense IDTaxonomies
FLME1199182085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology