MEDICARE: MARIA HENRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11041287	FL

General Provider Information

NPI Number	:	1053291989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA HENRY

Provider Business Mailing Address
First Line	:	3408 E 28TH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-1525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3408 E 28TH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-1525
Country	:	US
Telephone Number	:	813-564-7030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2025
Last Update Date	:	06/16/2026

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Directions to “ MARIA HENRY ” Practice Location

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