Provider Demographics
NPI:1093815508
Name:HELLER, DEAN R (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:R
Last Name:HELLER
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 1:9240 SUNSET DR BLDG 3
Mailing Address - Street 2:SUITE 116
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3261
Mailing Address - Country:US
Mailing Address - Phone:305-412-8315
Mailing Address - Fax:305-412-8936
Practice Address - Street 1:9240 SUNSET DR BLDG 3
Practice Address - Street 2:SUITE 116
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3261
Practice Address - Country:US
Practice Address - Phone:305-412-8315
Practice Address - Fax:305-412-8936
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 75869207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010458300Medicaid
FL43679Medicare ID - Type Unspecified
FLF69275Medicare UPIN