Healthcare Provider Details

I. General information

NPI: 1407791692
Provider Name (Legal Business Name): HENRY ROBERT DENIS LOUIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 SW 106TH AVE STE 105-106
CUTLER BAY FL
33157-7668
US

IV. Provider business mailing address

15214 SW 111TH CT
MIAMI FL
33157-1276
US

V. Phone/Fax

Practice location:
  • Phone: 305-233-4448
  • Fax:
Mailing address:
  • Phone: 786-247-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-525091
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: