Provider Demographics
NPI:1790817278
Name:HELLERSTEIN, DANIEL K (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:K
Last Name:HELLERSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:K
Other - Last Name:HELLERSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 5100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-650-0815
Practice Address - Fax:561-650-0819
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 58634208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4506635OtherAETNA
FLP1024507OtherFREEDOM
FL983306OtherWELLCARE
FL11636OtherBCBS
FL11636AOtherMEDICARE INDIVIDUAL PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
FL1050152OtherCAREPLUS
FL202339OtherAVMED
FLP971654OtherOPTIMUM
FLP01601012OtherRR MEDICARE
FL1891624OtherCIGNA
FL7433OtherDIMENSION HEALTH
FL11636AOtherMEDICARE INDIVIDUAL PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
FL4506635OtherAETNA