MEDICARE: DAVID R HEIMAN M D P A

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	207RG0100X	Gastroenterology Physician	ME0060847	FL

General Provider Information

NPI Number	:	1629267430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID R HEIMAN M D P A

Provider Business Mailing Address
First Line	:	4224 N TAMPANIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6322
Country	:	US
Telephone Number	:	813-877-3913
Fax Number	:	813-876-4793

Provider Business Practice Location Address
First Line	:	4224 N TAMPANIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6322
Country	:	US
Telephone Number	:	813-877-3913
Fax Number	:	813-876-4793

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID R HEIMAN
Credential	:	MD
Telephone Number	:	813-877-3913

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	03/03/2008

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