Provider Demographics
NPI:1265544886
Name:HEERS, RAYMOND A (CRNA)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:A
Last Name:HEERS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 S HUNT CLUB BLVD
Mailing Address - Street 2:#572
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4960
Mailing Address - Country:US
Mailing Address - Phone:407-620-3123
Mailing Address - Fax:
Practice Address - Street 1:522 S HUNT CLUB BLVD
Practice Address - Street 2:#572
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4960
Practice Address - Country:US
Practice Address - Phone:407-620-3123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCRNA00949367500000X
FL1013082367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered