Healthcare Provider Details

I. General information

NPI: 1215379490
Provider Name (Legal Business Name): ERIC G HECKERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

IV. Provider business mailing address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6413
  • Fax:
Mailing address:
  • Phone: 407-303-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: