Individual
WILLIAM DEREK HEINLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
14430 US HIGHWAY 1 STE 101, SEBASTIAN, FL 32958-3289
(772) 581-8003
(772) 581-8005
Mailing address
14430 US HIGHWAY 1 STE 101, SEBASTIAN, FL 32958-3289
(772) 581-8003
(772) 581-8005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA9115153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120201000
—
FL
Enumeration date
08/13/2021
Last updated
04/01/2025
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