Provider Demographics
NPI:1386637387
Name:HEGLEH, JOSEPH A (MD FACS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:HEGLEH
Suffix:
Gender:M
Credentials:MD FACS
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Mailing Address - Street 1:3195 TAMIAMI TRL
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8029
Mailing Address - Country:US
Mailing Address - Phone:941-883-2020
Mailing Address - Fax:941-883-3938
Practice Address - Street 1:3195 TAMIAMI TRL
Practice Address - Street 2:SUITE B
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8029
Practice Address - Country:US
Practice Address - Phone:941-883-2020
Practice Address - Fax:941-883-3938
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2012-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL81459207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58829OtherBCBS
FL268425000Medicaid
FL268425000Medicaid
300200937Medicare UPIN