Derek Henningsen
Derek Henningsen is an Exclusive Provider Organization in Debary, Florida. Practices as a sole proprietor. Licensed in Florida.
- Licensed in
- FL
- In the registry since
- 2016
Practice location Address checks out
132 Lucerne DrDebary, FL 32713-2914
Phone: (321) 363-6592
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Exclusive Provider Organization (primary) | Taxonomy 302F00000X · Licence W325026 (FL) |
|---|
Record details
| NPI number | 1992153209 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 26, 2016 |
| Last updated in NPPES | May 26, 2016 |
| Mailing address | 132 Lucerne Dr, Debary, FL 32713-2914 |