Heithaus, Robert Evans
Heithaus, Robert Evans is an sole proprietor health care provider with primary practice located at 1600 Sw Archer Rd 100374, Gainesville FL 32610-0374. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Heithaus, Robert Evans can be contacted via phone (352) 265-0291.Contact Information
Primary practice address
1600 Sw Archer Rd 100374
Gainesville FL 32610-0374
Phone: (352) 265-0291
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME130211 | Florida |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ME130211 | Florida |
Profile Details
| NPI number | 1285990739 |
|---|---|
| LBN Legal business name | Heithaus, Robert Evans |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 10th, 2012 |
| Last updated | Mar 27th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285990739 | NPPES |
| Florida | Other | E8Y3I | BCBS |
| Florida | Other | JK675Y | BCBS |
| Florida | Other | PS295 | BCBS |
| Florida | MEDICAID | 024688800 | BCBS |
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