Provider Demographics
NPI:1043582034
Name:HEIST, DORAN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DORAN
Middle Name:ROBERT
Last Name:HEIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7727 LAKE UNDERHILL RD
Mailing Address - Street 2:EMERGENCY MEDICINE RESIDENCY
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822
Mailing Address - Country:US
Mailing Address - Phone:407-303-6413
Mailing Address - Fax:407-303-6414
Practice Address - Street 1:7727 LAKE UNDERHILL RD
Practice Address - Street 2:EMERGENCY MEDICINE RESIDENCY
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822
Practice Address - Country:US
Practice Address - Phone:407-303-6413
Practice Address - Fax:407-303-6414
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111822207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME111822OtherFL STATE BOARD OF MEDICINE