Heideman, Andrew Charles
Heideman, Andrew Charles is an individual health care provider with primary practice located at 1325 San Marco Blvd Ste 102 Credentialing Department, Jacksonville FL 32207-8549. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Heideman, Andrew Charles can be contacted via phone (904) 858-7045.Contact Information
Primary practice address
1325 San Marco Blvd Ste 102 Credentialing Department
Jacksonville FL 32207-8549
Phone: (904) 858-7045
Fax: (904) 858-7047
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT21973 | Florida |
Profile Details
| NPI number | 1952306367 |
|---|---|
| LBN Legal business name | Heideman, Andrew Charles |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Feb 4th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952306367 | NPPES |
| Florida | Other | P00295808 | RR MEDICARE |
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