Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME58185 | FL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | ME58185 | FL |
NPI | 1275535817 |
---|---|
Provider Name | Dr. Walter R. Hepp |
First Address | Sarasota, FL 34239-3513 |
Second Address | Sarasota, FL 34239-3513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 06/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060063669 | MEDICARE RR (01) | FL |
064205300 | (05) | FL |
10902 | BCBS (01) | FL |
E59528 | (02) | FL |