Individual
DR. RANDY V HEYSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40107 HWY 27, DAVENPORT, FL 33837
(863) 419-0692
(863) 419-1695
Mailing address
PO BOX 90758, LAKELAND, FL 33804-0758
(407) 566-9899
(407) 566-9893
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME51222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048207200
—
FL
01
—
04944
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/04/2006
Last updated
11/27/2023
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