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NPI Code Detail

MEDICARE: DARREN HENRY

MEDICARE: DARREN HENRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS53456FL

General Provider Information

NPI Number : 1770958894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARREN HENRY
Provider Business Mailing Address
First Line : 619 BOURNE PL
Second Line :
City : ORLANDO
State : FL
Zip : 32801-3906
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 820 OVIEDO MALL BLVD
Second Line :
City : OVIEDO
State : FL
Zip : 32765-9348
Country : US
Telephone Number : 407-366-5907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2015
Last Update Date : 12/01/2015

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Directions to “ DARREN HENRY ” Practice Location

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