Individual
DE'RICO HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
7919 COURTLEIGH DR, ORLANDO, FL 32835-5930
(191) 651-2991
Mailing address
7919 COURTLEIGH DR, ORLANDO, FL 32835-5930
(191) 651-2991
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/30/2022
Last updated
07/30/2022
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