MEDICARE: ERIN ASHLEY 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	208800000X	Urology Physician	ME162798	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
2	WF368	OTHER	FL	HFMG

General Provider Information

NPI Number	:	1396241774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN ASHLEY HEITMAN MD

Provider Business Mailing Address
First Line	:	4571 COLONIAL BLVD STE 110
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-1156
Country	:	US
Telephone Number	:	239-264-7180
Fax Number	:	239-333-1702

Provider Business Practice Location Address
First Line	:	9500 BONITA BEACH RD SE STE 201
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-4683
Country	:	US
Telephone Number	:	239-374-5220
Fax Number	:	239-567-3649

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

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	11/04/2025

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