Provider Demographics
NPI:1639479926
Name:HEYDEN, EDWARD BALBACH (EDD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:BALBACH
Last Name:HEYDEN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 S OCEAN DR
Mailing Address - Street 2:1001
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7255
Mailing Address - Country:US
Mailing Address - Phone:954-673-5743
Mailing Address - Fax:
Practice Address - Street 1:3180 S OCEAN DR
Practice Address - Street 2:1001
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7255
Practice Address - Country:US
Practice Address - Phone:954-673-5743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8121103T00000X
DEB116103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist