Individual
DR. TERRY R. VAN DER HEYDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4060 TAMIAMI TRL N, SUITE 4, NAPLES, FL 34103-3596
(239) 261-5915
Mailing address
4060 TAMIAMI TRL N, SUITE 4, NAPLES, FL 34103-3596
(239) 261-5915
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC001061
FL
332H00000X
Eyewear Supplier
OPC001061
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410013850
RAILROAD MEDICARE
FL
Enumeration date
08/17/2005
Last updated
10/11/2010
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