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Individual

MR. CARSON HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
928 S DIXIE HWY UNIT 470, LANTANA, FL 33462-4653
(561) 794-5068
Mailing address
928 S DIXIE HWY UNIT 470, LANTANA, FL 33462-4653

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110010390
VA
363A00000X
Physician Assistant
PA66190
CA
363A00000X
Physician Assistant
Primary
PA9118746
FL

Other

Enumeration date
04/04/2024
Last updated
04/05/2025
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