Provider Demographics
NPI:1881691723
Name:HECHT, GARY DAVID (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:DAVID
Last Name:HECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-5143
Mailing Address - Country:US
Mailing Address - Phone:386-736-3110
Mailing Address - Fax:386-738-1683
Practice Address - Street 1:1000 W NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-5143
Practice Address - Country:US
Practice Address - Phone:386-736-3110
Practice Address - Fax:386-738-1683
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040894207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D57735Medicare UPIN
64578Medicare ID - Type Unspecified