Provider Demographics
NPI:1811243611
Name:HEURICH, EVA-MARIA (DO)
Entity type:Individual
Prefix:DR
First Name:EVA-MARIA
Middle Name:
Last Name:HEURICH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W GORE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1041
Mailing Address - Country:US
Mailing Address - Phone:407-210-1346
Mailing Address - Fax:407-426-9290
Practice Address - Street 1:100 W GORE ST STE 202
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1041
Practice Address - Country:US
Practice Address - Phone:407-210-1346
Practice Address - Fax:407-426-9290
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine