Hedrick, Jerry Leo

Hedrick, Jerry Leo is an individual health care provider with primary practice located at 500 Vonderburg Drive Ste 115W, Brandon FL 33511-5969. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Hedrick, Jerry Leo can be contacted via phone (813) 685-0306.

Contact Information

Primary practice address
500 Vonderburg Drive Ste 115W Brandon FL 33511-5969
Phone: (813) 685-0306
Fax: (813) 651-1026
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME38730 Florida

Profile Details

NPI number 1164457412
LBN Legal business name Hedrick, Jerry Leo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Nov 6th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164457412 NPPES
Florida Other 070000215 RAILROAD MEDICARE
Florida MEDICAID 101936200 RAILROAD MEDICARE
Florida Other 30425 RAILROAD MEDICARE

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