Provider Demographics
NPI:1487394920
Name:HEINE, RUBY LEE
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:LEE
Last Name:HEINE
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 1:8301 N TINY LILY DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-6644
Mailing Address - Country:US
Mailing Address - Phone:352-942-4889
Mailing Address - Fax:
Practice Address - Street 1:8301 N TINY LILY DR
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-6644
Practice Address - Country:US
Practice Address - Phone:352-942-4889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty