Provider Demographics
NPI:1649536731
Name:HEFT, JESSICA SANDERSON (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SANDERSON
Last Name:HEFT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 100294 1600 SW ARCHER RD ROOM N3-9
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0294
Mailing Address - Country:US
Mailing Address - Phone:352-273-7580
Mailing Address - Fax:352-627-4375
Practice Address - Street 1:1549 GALE LEMERAND DR FL 4
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3008
Practice Address - Country:US
Practice Address - Phone:352-265-8200
Practice Address - Fax:352-627-4375
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2020-12-28
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Provider Licenses
StateLicense IDTaxonomies
FLME139372207VF0040X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103632100Medicaid