1. Home
  2. Directory
  3. Florida
  4. Lake Mary
  5. Family Medicine
  6. NPI Profile

HEATHROW INTERNAL MEDICINE LLC
NPI 1033387865
Family Medicine in Lake Mary, FL

Active since February 14, 2008CLIA 10D0705869 · Waiver
4106 W LAKE MARY BLVD, SUITE 100, LAKE MARY, FL 32746(407) 333-2273(407) 333-3939 Get Directions Write a Review

NPPES record last updated: May 28, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Heathrow Internal Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEATHROW INTERNAL MEDICINE LLC (NPI 1033387865) is a healthcare organization registered as a family medicine in Lake Mary, Florida and active in the NPI registry since February 2008. The organization holds a CLIA Waiver certificate valid through July 14, 2028 and lists Tedrick Johnson, Group Vp Operations, as its authorized official.

NPPES Registry Identity

NPI1033387865
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHEATHROW INTERNAL MEDICINE LLC
Location Address4106 W LAKE MARY BLVD, SUITE 100Lake Mary, FL 32746-3315
Mailing Address4106 W Lake Mary Blvd, Suite 100Lake Mary, FL 32746-3315 · (407) 333-2273 · Fax (407) 333-3939
Phone(407) 333-2273
Fax(407) 333-3939
Organization SubpartNo
Authorized OfficialTedrick JohnsonGroup Vp Operations · (407) 333-2273
Enumeration DateFebruary 14, 2008
Last NPPES UpdateMay 28, 2014
✔ NPI 1033387865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X
4106 W LAKE MARY BLVD, Lake Mary, FL 32746
Open in Google Maps ↗

Other Identifiers 4

OtherPTAN DN9084FL · Medicare Railroad
OtherAM199FL · Medicare Ptan
Medicaid307909100FL
Medicaid000617400FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0705869

Heathrow Internal Medicine LLC - Hca Florida Lake Mary Primary Care · Lake Mary, FL
Active · expires Jul 14, 2028
CLIA Number10D0705869
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorJesse W. Johnson Jr
Laboratory Phone(407) 333-2273
Laboratory LocationHeathrow Internal Medicine LLC - Hca Florida Lake Mary Primary Care4106 W Lake Mary Blvd Ste 100, Lake Mary, FL 32746
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTOPHER C MASON DPM
Podiatrist (Foot & Ankle Surgery)
4106 W LAKE MARY BLVD, 125
LAKE MARY, FL 32746
Seminole County (497) 333-3668
JOHN MAURIELLO M.D.
Phlebology
4106 W LAKE MARY BLVD, SUITE 324
LAKE MARY, FL 32746
Seminole County (407) 892-8484
WILLIAM L HUETHER III M.D.
Surgery
4106 W LAKE MARY BLVD, SUITE 330
LAKE MARY, FL 32746
Seminole County (407) 833-9195
BRIAN L CAMERON M.D.
Surgery
4106 W LAKE MARY BLVD, SUITE 330
LAKE MARY, FL 32746
Seminole County (407) 833-9195
JOHN W. ROBERTSON M.D.
Surgery
4106 W LAKE MARY BLVD, SUITE 330
LAKE MARY, FL 32746
Seminole County (407) 833-9195
DR. DIWYA U RANJIT M.D
Internal Medicine
4106 W LAKE MARY BLVD, SUITE 100
LAKE MARY, FL 32746
Seminole County (407) 333-2273
FLORIDA INTERNAL MEDICINE PA
Internal Medicine
4106 W LAKE MARY BLVD, SUITE 301
LAKE MARY, FL 32746
Seminole County (407) 333-2503
GLEN F. DAVIS M.D.
Internal Medicine
4106 W LAKE MARY BLVD, SUITE 301
LAKE MARY, FL 32746
Seminole County (407) 333-2503

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heathrow Internal Medicine LLC's NPI number?

The NPI number for Heathrow Internal Medicine LLC is 1033387865. It was assigned to this organization in the NPPES registry on February 14, 2008.

Where is Heathrow Internal Medicine LLC located?

Heathrow Internal Medicine LLC is located at 4106 W Lake Mary Blvd Suite 100, Lake Mary, FL 32746. The listed phone number is (407) 333-2273.

What is Heathrow Internal Medicine LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Heathrow Internal Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0705869) is associated with this NPI, valid through July 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Heathrow Internal Medicine LLC accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 3 other insurers list Heathrow Internal Medicine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Heathrow Internal Medicine LLC was last updated on May 28, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.