Henderson, David A

Henderson, David A is an individual health care provider with primary practice located at 305 Memorial Medical Pkwy Suite 301, Daytona Beach FL 32117-5168. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Henderson, David A can be contacted via phone (386) 677-5351.

Contact Information

Primary practice address
305 Memorial Medical Pkwy Suite 301 Daytona Beach FL 32117-5168
Fax: (386) 673-2787
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME0038731 Florida

Profile Details

NPI number 1750332250
LBN Legal business name Henderson, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Dec 6th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750332250 NPPES
Florida MEDICAID 043002100

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