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Individual

MR. ROBERT C HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4600 N HABANA AVE STE 30, TAMPA, FL 33614-7123
(813) 879-6603
(813) 879-6805
Mailing address
4600 N HABANA AVE STE 30, TAMPA, FL 33614-7123
(813) 879-6603
(813) 879-6805

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0036678
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
067431100
FL
Enumeration date
11/08/2006
Last updated
10/21/2013
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