Healthcare Provider Details

I. General information

NPI: 1851449995
Provider Name (Legal Business Name): ALFONSO J HENRIQUEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 FOREST HILL BLVD
WEST PALM BEACH FL
33406-5931
US

IV. Provider business mailing address

2640 FOREST HILL BLVD
WEST PALM BEACH FL
33406-5931
US

V. Phone/Fax

Practice location:
  • Phone: 561-275-7100
  • Fax: 561-275-7199
Mailing address:
  • Phone: 561-275-7100
  • Fax: 561-275-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME98652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: