Healthcare Provider Details

I. General information

NPI: 1518929421
Provider Name (Legal Business Name): ROY GILBERT HEILBRON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4302 ALTON RD #530
MIAMI BEACH FL
33140
US

IV. Provider business mailing address

4302 ALTON RD #530
MIAMI BEACH FL
33140
US

V. Phone/Fax

Practice location:
  • Phone: 305-531-6886
  • Fax: 305-531-9992
Mailing address:
  • Phone: 305-531-6886
  • Fax: 305-531-9992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME 63434
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: