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Individual

DR. TIMOTHY JAMES HENNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
3150 CITRUS TOWER BLVD, SUITE B, CLERMONT, FL 34711-6802
(352) 242-2502
(352) 242-0316
Mailing address
3190 CITRUS TOWER BLVD, STE A, CLERMONT, FL 34711-6886
(352) 242-2502
(352) 242-0316

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3047
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
043604213
CIGNA
FL
05
340361100
FL
01
4690780001
PALMETTO GBA
FL
01
65802
BC/BS
FL
01
P00071261
RAILROAD MEDICARE
FL
Enumeration date
07/12/2006
Last updated
05/21/2018
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