| Doctor Name: | DR. TERRY R. VAN DER HEYDEN |
| NPI Number: | 1932191756 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | O.D. |
| License Number: | OPC001061 |
| Business Practice Address: | 4060 Tamiami Trl N Suite 4 Naples, FL - 341033596 |
| Business Phone Number: | 2392615915 |
| Business Fax Number: | |
| Mailing Address: | 4060 Tamiami Trl N, Suite 4 NAPLES |
| State: | FL |
| Postal Code: | 341033596 |
| Phone Number: | 2392615915 |
| Fax Number: | |
| NPI Enumeration Date: | 08/17/2005 |
| NPI Last Update Date: | 10/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | OPC001061 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |