Individual
KEVIN L HENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
410 E CENTRAL AVE, WINTER HAVEN, FL 33880-3050
(863) 293-0276
(863) 299-3172
Mailing address
410 E CENTRAL AVE, WINTER HAVEN, FL 33880-3050
(863) 293-0276
(863) 299-3172
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
FL1655
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0782670
—
FL
01
—
41000187
RAILROAD MEDICARE
—
Enumeration date
10/28/2005
Last updated
04/24/2009
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