Healthcare Provider Details

I. General information

NPI: 1730369729
Provider Name (Legal Business Name): HENKIN NEUROSURGERY P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 PROFESSIONAL PARK DR
BRANDON FL
33511-4886
US

IV. Provider business mailing address

1007 PROFESSIONAL PARK DR
BRANDON FL
33511-4886
US

V. Phone/Fax

Practice location:
  • Phone: 813-651-3300
  • Fax: 813-651-4455
Mailing address:
  • Phone: 813-651-3300
  • Fax: 813-651-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILIP HENKIN
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 813-651-3300