Provider Demographics
NPI:1710235502
Name:HEATHER M GUIDEBECK, D.C.
Entity Type:Organization
Organization Name:HEATHER M GUIDEBECK, D.C.
Other - Org Name:HEATHER M GUIDEBECK, D.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIDEBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-618-3033
Mailing Address - Street 1:3745 11TH CIR STE 106
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4838
Mailing Address - Country:US
Mailing Address - Phone:772-618-3033
Mailing Address - Fax:772-672-7580
Practice Address - Street 1:3745 11TH CIR STE 106
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4838
Practice Address - Country:US
Practice Address - Phone:772-563-2900
Practice Address - Fax:772-563-2961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU82169Medicare UPIN