Organization Active NPI

Loretta V Henderson DPM

  • Durable Medical Equipment & Medical Supplies
  • Kissimmee, FL
National Provider Identifier
1124264114
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
PO1685 Issued in FL
Legal business name
LORETTA V HENDERSON DPM
Practice address
1543 Aldersgate Dr
Kissimmee, FL 34746-6545
Phone
(866) 365-3668
Fax
(407) 870-7753
NPI assigned
Dec 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Loretta V Henderson, DPM
Title
Proprietor
Phone
(866) 365-3668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PO1685 FL Primary

Addresses

Primary practice location

1543 Aldersgate Dr
Kissimmee, FL 34746-6545

Mailing address

PO Box 720849
Orlando, FL 32872-0849
Phone (866) 365-3668

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229990400000",
    "number": "1124264114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720849",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328720849",
            "telephone_number": "866-365-3668",
            "fax_number": "407-870-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 ALDERSGATE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347466545",
            "telephone_number": "866-365-3668",
            "fax_number": "407-870-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORETTA V HENDERSON DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-23",
        "last_updated": "2008-12-23",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "866-365-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PO1685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.