Goedicke, Heidi Rebecca

Goedicke, Heidi Rebecca is an individual health care provider with primary practice located at 1921 Waldemere St Ste 705 , Sarasota FL 34239-2913. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Goedicke, Heidi Rebecca can be contacted via phone (941) 366-5864.

Contact Information

Primary practice address
1921 Waldemere St Ste 705 Sarasota FL 34239-2913
Phone: (941) 366-5864
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X ME123843 Florida
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X ME123843 Florida

Profile Details

NPI number 1255633509
LBN Legal business name Goedicke, Heidi Rebecca
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2010
Last updated Jan 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255633509 NPPES
Pennsylvania Other MT194750 MEDICAL TRAINING LICENSE NUMBER
Pennsylvania MEDICAID 014836900 MEDICAL TRAINING LICENSE NUMBER
Pennsylvania Other TRN17847 MEDICAL TRAINING LICENSE NUMBER

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