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NPI Code Detail

MEDICARE: SEAN P HERON M.D.

MEDICARE: SEAN P HERON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianME68349FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1700823OTHERAETNA HMO
2938007OTHERFIRST HEALTH
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
48207862OTHERAETNA PPO
52990017001OTHERCIGNA
627138OTHERBCBS OF FLORIDA
7591226600OTHERUNITED HEALTHCARE

General Provider Information

NPI Number : 1164486262
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN P HERON M.D.
Provider Business Mailing Address
First Line : 12109 COUNTY ROAD 103
Second Line :
City : OXFORD
State : FL
Zip : 34484-2951
Country : US
Telephone Number : 352-205-8981
Fax Number :
Provider Business Practice Location Address
First Line : 5747 38TH AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33710-1925
Country : US
Telephone Number : 727-381-8667
Fax Number : 727-345-1951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 11/29/2023

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Directions to “ SEAN P HERON M.D.” Practice Location

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