Heideman, Andrew Charles

Heideman, Andrew Charles is an individual health care provider with primary practice located at 1325 San Marco Blvd Ste 102 Credentialing Department, Jacksonville FL 32207-8549. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Heideman, Andrew Charles can be contacted via phone (904) 858-7045.

Contact Information

Primary practice address
1325 San Marco Blvd Ste 102 Credentialing Department Jacksonville FL 32207-8549
Phone: (904) 858-7045
Fax: (904) 858-7047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT21973 Florida

Profile Details

NPI number 1952306367
LBN Legal business name Heideman, Andrew Charles
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Feb 4th, 2015 - about 9 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 1952306367 NPPES
Florida Other P00295808 RR MEDICARE

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