MEDICARE: DR. JEFFREY S HENN M.D.

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	207T00000X	Neurological Surgery Physician	ME85279	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME852798	OTHER	FL	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821064957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY S HENN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-337-2003
Fax Number	:	239-337-3168

Provider Business Practice Location Address
First Line	:	7331 COLLEGE PKWY STE 300
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5524
Country	:	US
Telephone Number	:	239-337-2003
Fax Number	:	239-337-3168

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	10/12/2023

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