Henderson, Michael John

Henderson, Michael John is an individual health care provider with primary practice located at 13670 Walsingham Rd , Largo FL 33774-3532. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Henderson, Michael John can be contacted via phone (727) 315-6974.

Contact Information

Primary practice address
13670 Walsingham Rd Largo FL 33774-3532
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9113306 Florida

Profile Details

NPI number 1558523951
LBN Legal business name Henderson, Michael John
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2008
Last updated May 19th, 2023 - about last year

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 1558523951 NPPES
Florida MEDICAID 114317600

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