1841812450 NPI number — SENSIBLE FAMILY HEALTHCARE, LLC

Table of content: HEIDI JOAN LETKO LPC, LAC, QMHP (NPI 1417976556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841812450 NPI number — SENSIBLE FAMILY HEALTHCARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENSIBLE FAMILY HEALTHCARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841812450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2959 ALAFAYA TRAIL
Provider Second Line Business Mailing Address:
SUITE 117
Provider Business Mailing Address City Name:
OVIEDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32765-9482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-604-3003
Provider Business Mailing Address Fax Number:
407-604-3067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2959 ALAFAYA TRL STE 117
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OVIEDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32765-9482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-506-4665
Provider Business Practice Location Address Fax Number:
407-604-3067
Provider Enumeration Date:
05/18/2020

Additional Information

Authorized Official

Authorized Official Last Name:
WARRINGTON
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
GARRETT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
407-506-4665

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 109742900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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