Organization
BAY DERMATOLOGY ASSOCIATES JERRY L HEDRICK MD PA
Active
Organization
BAY DERMATOLOGY ASSOCIATES JERRY L HEDRICK MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY LEO HEDRICK MD PA (PHYSICIAN)
(813) 685-0306
Entity
Organization
Contact information
Practice address
500 VONDERBURG DRIVE, STE 115W, BRANDON, FL 33511-5969
(813) 685-0306
(813) 651-1026
Mailing address
500 VONDERBURG DRIVE, STE 115W, BRANDON, FL 33511-5969
(813) 685-0306
(813) 651-1026
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME38730
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0667336
AETNA
FL
01
—
070000215
RAILROAD MEDICARE
FL
01
—
30425
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/10/2006
Last updated
01/15/2010
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