Healthcare Provider Details

I. General information

NPI: 1851625800
Provider Name (Legal Business Name): MARVIN ARTHUR HEUER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 09/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 VINELAND RD SUITE 104
ORLANDO FL
32819-7829
US

IV. Provider business mailing address

4630 S KIRKMAN RD SUITE 368
ORLANDO FL
32811-2833
US

V. Phone/Fax

Practice location:
  • Phone: 407-574-5650
  • Fax: 407-362-6292
Mailing address:
  • Phone: 407-574-5650
  • Fax: 407-362-6292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME72101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: