Heidi Marie Gonzalez
Optometrist
4263 Legendary Dr Ste J-105
Destin
, Florida 32541-5392
Heidi Marie Gonzalez
Optometrist
4263 Legendary Dr Ste J-105
Destin
, Florida 32541-5392
(334) 791-0546
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Heidi Marie Gonzalez
- 470 Turquoise Bch Dr
- Santa Rosa Beach, FL
- Zip : 32459-3061
- Phone : (334) 791-0546
Second Address
- Heidi Marie Gonzalez
- 4263 Legendary Dr Ste J-105
- Destin, FL
- Zip : 32541-5392
- Fax : (850) 583-3632
- Phone : (850) 389-6132
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPC 4646 | FL |
National Provider Identifier
| NPI | 1003196783 |
|---|---|
| Provider Name | Heidi Marie Gonzalez |
| First Address | Santa Rosa Beach, FL 32459-3061 |
| Second Address | Destin, FL 32541-5392 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/08/2011 |
| Last Update Date | 24/08/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.