Healthcare Provider Details

I. General information

NPI: 1255034351
Provider Name (Legal Business Name): MARIA D HENRIQUEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RAWLINS DR
SEAFORD DE
19973-5881
US

IV. Provider business mailing address

100 RAWLINS DR
SEAFORD DE
19973-5881
US

V. Phone/Fax

Practice location:
  • Phone: 302-990-3300
  • Fax: 302-575-8005
Mailing address:
  • Phone: 302-990-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC1-0029769
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: