MEDICARE: MR. TONY HELDORE

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	172A00000X	Driver	H436-800-70-157-0	FL

General Provider Information

NPI Number	:	1710779962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TONY HELDORE

Provider Business Mailing Address
First Line	:	3061 NW 204TH LN
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-2028
Country	:	US
Telephone Number	:	352-235-9467
Fax Number	:	352-235-9467

Provider Business Practice Location Address
First Line	:	3061 NW 204TH LN
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-2028
Country	:	US
Telephone Number	:	352-235-9467
Fax Number	:	352-235-9467

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

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	05/21/2025

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