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General NPI Number Information
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NPI Number | 1750552907
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Entity Type | Organization
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Legal Business Name | HECKER DERMATOLOGY GROUP P.A.
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 04/20/2010
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Provider Practice Location Address
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Address Line | 3500 NE 5TH AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4445
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Country | US
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Telephone | 954-783-2323
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Fax | 954-783-2321
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Provider Business Mailing Address
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Address Line | 3500 NE 5TH AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33064
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Country | US
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Telephone | 954-783-2323
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Fax | 954-783-2321
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Authorized Official
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Title or Position | DIRECTOR
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Name | MELANIE SCHWARTZ HECKER
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Credential | M.D,
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Telephone | 954-783-2323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME79381
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License Number State | FL
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