Provider Demographics
NPI:1851965578
Name:ESAA, HELY (PA)
Entity Type:Individual
Prefix:
First Name:HELY
Middle Name:
Last Name:ESAA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 SUMMIT CREEK BLVD APT 4305
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5592
Mailing Address - Country:US
Mailing Address - Phone:407-723-9787
Mailing Address - Fax:
Practice Address - Street 1:4303 SUMMIT CREEK BLVD APT 4305
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-5592
Practice Address - Country:US
Practice Address - Phone:407-723-9787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR699PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty