Provider Demographics
NPI:1851625800
Name:HEUER, MARVIN ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:ARTHUR
Last Name:HEUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4630 S KIRKMAN RD
Mailing Address - Street 2:SUITE 368
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-2833
Mailing Address - Country:US
Mailing Address - Phone:407-574-5650
Mailing Address - Fax:407-362-6292
Practice Address - Street 1:6001 VINELAND RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7829
Practice Address - Country:US
Practice Address - Phone:407-574-5650
Practice Address - Fax:407-362-6292
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME72101208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFO199OMedicare UPIN