Provider Demographics
NPI:1235248238
Name:HECKER, DAVID JAY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAY
Last Name:HECKER
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 1:3500 NE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-4445
Mailing Address - Country:US
Mailing Address - Phone:954-781-2969
Mailing Address - Fax:954-781-2889
Practice Address - Street 1:3500 NE 5TH AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-4445
Practice Address - Country:US
Practice Address - Phone:954-781-2969
Practice Address - Fax:954-781-2889
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78709207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3146VOtherPTAN
FLG90840Medicare UPIN