Individual
COREY A HEICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
795 PRIMERA BLVD STE 1001, LAKE MARY, FL 32746-2191
(386) 561-9967
(844) 815-1446
Mailing address
795 PRIMERA BLVD STE 1001, LAKE MARY, FL 32746-2191
(386) 561-9967
(844) 815-1446
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2134
SC
363AM0700X
Medical Physician Assistant
Primary
2134
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1944PA
—
SC
Enumeration date
07/31/2007
Last updated
08/08/2024
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