Healthcare Provider Details

I. General information

NPI: 1548285893
Provider Name (Legal Business Name): ANDREA RHONEA HENLEY-SEYMOUR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA RHONEA HENLEY M.D.

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11581 NW 24TH ST
PLANTATION FL
33323-2033
US

IV. Provider business mailing address

11581 NW 24TH ST
PLANTATION FL
33323-2033
US

V. Phone/Fax

Practice location:
  • Phone: 770-880-6514
  • Fax:
Mailing address:
  • Phone: 770-880-6514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME97055
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME97055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: