Healthcare Provider Details

I. General information

NPI: 1629412002
Provider Name (Legal Business Name): CHRISTINA HENRY D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ANTHEM VILLAGE DR STE 100
HENDERSON NV
89052-5562
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 702-843-1437
  • Fax: 702-832-5775
Mailing address:
  • Phone: 702-843-2440
  • Fax: 833-749-0349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberUO3364
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO1997
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: