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Individual

DR. DAREL HEITKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
601 E ROLLINS ST, ORLANDO, FL 32803
(407) 303-5600
Mailing address
2600 WESTHALL LN FL 4, MAITLAND, FL 32751-7102

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01053809
IN
2085R0202X
Diagnostic Radiology Physician
Primary
ME136685
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200491730
IN
01
P00176837
RAILROAD MEDICARE
IN
Enumeration date
06/04/2006
Last updated
07/07/2018
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