Provider Demographics
NPI:1356417786
Name:GUIDEBECK, HEATHER M (DC)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:M
Last Name:GUIDEBECK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 HIGHWAY A1A STE 214
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2250
Mailing Address - Country:US
Mailing Address - Phone:772-618-3033
Mailing Address - Fax:772-672-7580
Practice Address - Street 1:1701 HIGHWAY A1A STE 214
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2250
Practice Address - Country:US
Practice Address - Phone:772-618-3033
Practice Address - Fax:772-672-7580
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53891Medicare ID - Type Unspecified
FLU82169Medicare UPIN