MEDICARE: WILLIAM HARRY HEITMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME070883	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184631764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HARRY HEITMAN MD

Provider Business Mailing Address
First Line	:	2401 FRIST BLVD
Second Line	:	SUITE 5
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4839
Country	:	US
Telephone Number	:	772-465-8100
Fax Number	:	772-465-8615

Provider Business Practice Location Address
First Line	:	2401 FRIST BLVD
Second Line	:	SUITE 5
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4839
Country	:	US
Telephone Number	:	772-465-8100
Fax Number	:	772-465-8615

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	04/07/2016

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