Provider Demographics
NPI:1689257024
Name:HELLER, STEVEN LEE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LEE
Last Name:HELLER
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:255 WHEELHOUSE LN APT 523
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3823
Mailing Address - Country:US
Mailing Address - Phone:407-697-0644
Mailing Address - Fax:
Practice Address - Street 1:7051 SEACREST BLVD
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-5139
Practice Address - Country:US
Practice Address - Phone:561-296-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9114331363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty