Robert C Henderson, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0036678 Issued in FL

Practice address

4600 N Habana Ave Ste 30
Tampa, FL 33614-7123

Phone

(813) 879-6603

Fax

(813) 879-6805

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1972673838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 N HABANA AVE STE 30",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147123",
            "telephone_number": "813-879-6603",
            "fax_number": "813-879-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N HABANA AVE STE 30",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147123",
            "telephone_number": "813-879-6603",
            "fax_number": "813-879-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0036678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067431100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Jane Henderson, MS CCC SLP
• Lester Henderson
• Lura Marie Henderson, ARNP, MSN, AOCNP
• Marsha Henderson, LMHC
• Megan Henderson, M.A. BCBA
• Steven Henderson
• Tisha Henderson, CAP
• Titus Henderson
• Andrea Hendley
• Yovonne Germaine Hendley, PHARMD

• Specialist in Tampa, FL
• Providers in Tampa, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; 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.