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General NPI Number Information
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NPI Number | 1083885958
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Entity Type | Organization
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Legal Business Name | ALBERT L HENRY, MD
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 1665 KINGSLEY AVE STE 107
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City | ORANGE PARK
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State | FL
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Zip | 32073-4415
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Country | US
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Telephone | 904-269-6565
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Fax | 904-264-0529
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Provider Business Mailing Address
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Address Line | 1665 KINGSLEY AVE STE 107
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City | ORANGE PARK
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State | FL
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Zip | 32073-4415
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Country | US
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Telephone | 904-269-6565
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Fax | 904-264-0529
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. WENDY ROBYN HUGHES
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Credential |
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Telephone | 904-269-6565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | ME0054173
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License Number State | FL
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