Provider Demographics
NPI:1043265507
Name:HENRYS, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:HENRYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 N.W. 95TH STREET, SUITE 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2066
Mailing Address - Country:US
Mailing Address - Phone:305-302-8858
Mailing Address - Fax:305-693-6942
Practice Address - Street 1:100 NW 170TH
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-9800
Practice Address - Country:US
Practice Address - Phone:305-654-3000
Practice Address - Fax:305-654-3000
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39185207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery