HERON MEDICAL PLLC NPI 1487184610

NPI Information

HERON MEDICAL PLLC is a multi-specialty clinic center in Salt Lake City, UT. HERON MEDICAL PLLC NPI is 1487184610. The provider is registered as an organization entity type.
The provider Is Doing Business As Amy De La Garza, Md.

The provider's business location address is:

77 S 700 E STE 220
SALT LAKE CITY, UT
ZIP 84102-162
Phone: (801) 910-6189

The provider's authorized official is Amy Noel De La Garza .
The authorized official title is Owner and has the following contact phone number (801) 910-6189.

The CLIA number assigned to this NPI record is 46D2134734 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2017 and was last updated on 6/20/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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