Healthcare Provider Details

I. General information

NPI: 1902188519
Provider Name (Legal Business Name): JOSEPH ANTHONY HEGEDUS RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 12/17/2022
Certification Date: 12/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 S KIRKMAN RD
ORLANDO FL
32811-2203
US

IV. Provider business mailing address

920 S KIRKMAN RD
ORLANDO FL
32811-2203
US

V. Phone/Fax

Practice location:
  • Phone: 407-253-6288
  • Fax: 407-253-6292
Mailing address:
  • Phone: 407-253-6288
  • Fax: 407-253-6292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS32624
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: