Organization
ROBERT C HENDERSON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT CONNAR HENDERSON MD (OWNER/OPERATOR)
(813) 879-6603
Entity
Organization
Contact information
Practice address
4600 N HABANA AVE, 30, TAMPA, FL 33614-7112
(813) 879-6603
(813) 879-6805
Mailing address
4600 N HABANA AVE, 30, TAMPA, FL 33614-7112
(813) 879-6603
(813) 879-6805
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0036678
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067431100
—
FL
Enumeration date
07/28/2010
Last updated
07/28/2010
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