| Organization Name: | HEARTLAND PEDIATRICS ASSOCIATION OF WAUCHULA, P.A. |
| NPI Number: | 1144241134 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | APURBA MANIK (PRESIDENT) |
| Mailing Address: | 120 Heartland Way Wauchula |
| State: | FL US |
| Postal Code: | 338735000 |
| Phone Number: | 8637671414 |
| Fax Number: | 8637671763 |
| NPI Enumeration Date: | 07/22/2006 |
| NPI Last Update Date: | 01/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |