MEDICARE: DR. DANIEL K HELLERSTEIN 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	ME 58634	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	11636A	OTHER	FL	MEDICARE INDIVIDUAL PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
9	P01601012	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4506635	OTHER	FL	AETNA
2	P1024507	OTHER	FL	FREEDOM
3	983306	OTHER	FL	WELLCARE
4	11636	OTHER	FL	BCBS
6	1050152	OTHER	FL	CAREPLUS
7	202339	OTHER	FL	AVMED
8	P971654	OTHER	FL	OPTIMUM
10	1891624	OTHER	FL	CIGNA
11	7433	OTHER	FL	DIMENSION HEALTH

General Provider Information

NPI Number	:	1790817278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL K HELLERSTEIN MD

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: PAYER CONTRACTING & RELATIONS DEPT.
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	1411 N FLAGLER DR
Second Line	:	SUITE 5100
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-3404
Country	:	US
Telephone Number	:	561-650-0815
Fax Number	:	561-650-0819

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

Provider Enumeration Date	:	03/11/2007
Last Update Date	:	11/10/2016

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