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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DEREK HENNINGSEN

Active Sole Proprietor

DEREK HENNINGSEN is a Exclusive Provider Organization healthcare provider located in DEBARY, Florida. NPI 1992153209 is currently active in the NPPES registry. Verify at CMS.

Exclusive Provider Organization · DEBARY, FL

Registration Details

NPI Number
1992153209
Provider Type
Individual
Gender
Male
NPI Issued
May 26, 2016 (10.229426164559 yrs)
Last Updated
May 26, 2016
License
W325026 (FL)
Sole Proprietor
Yes

Practice Information

Address
132 LUCERNE DR
DEBARY, FL, 327132914
Browse FL providers · Browse ZIP 32713
Phone
3213636592
Primary Specialty
Exclusive Provider Organization
302F00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.