Provider Demographics
NPI:1861054165
Name:HEFLIN, KATINA DENISE
Entity type:Individual
Prefix:
First Name:KATINA
Middle Name:DENISE
Last Name:HEFLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 SIMMONS AVE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-3797
Mailing Address - Country:US
Mailing Address - Phone:352-551-6374
Mailing Address - Fax:
Practice Address - Street 1:2120 SIMMONS AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3797
Practice Address - Country:US
Practice Address - Phone:352-551-6374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care