Healthcare Provider Details

I. General information

NPI: 1497765580
Provider Name (Legal Business Name): ROBERT JAY HELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7308 BARCLAY CT
UNIVERSITY PARK FL
34201-2340
US

IV. Provider business mailing address

7308 BARCLAY CT
UNIVERSITY PARK FL
34201-2340
US

V. Phone/Fax

Practice location:
  • Phone: 863-272-4118
  • Fax:
Mailing address:
  • Phone: 863-272-4118
  • Fax: 443-262-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number01061233A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME33832
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: