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Individual
JOSE LUIS HENAO
Active
Individual
JOSE LUIS HENAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13298
SD
207RN0300X
Nephrology Physician
Primary
MD2023-1540
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15136728
—
NM
01
—
6L7121
MEDICARE
NM
Enumeration date
04/12/2017
Last updated
10/27/2025
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