Provider Demographics
NPI:1972921781
Name:PRESENDIEU, HEDEN
Entity Type:Individual
Prefix:DR
First Name:HEDEN
Middle Name:
Last Name:PRESENDIEU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 NE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-3862
Mailing Address - Country:US
Mailing Address - Phone:561-715-4058
Mailing Address - Fax:
Practice Address - Street 1:1054 GATEWAY BLVD STE 109
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8309
Practice Address - Country:US
Practice Address - Phone:561-715-4058
Practice Address - Fax:850-633-2424
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9340017363LP0808X, 363LF0000X
FLME157838207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily