Provider Demographics
NPI:1114572757
Name:CHAPERON, HENRI D
Entity Type:Individual
Prefix:
First Name:HENRI
Middle Name:D
Last Name:CHAPERON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5918 APPALOOSA WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-4213
Mailing Address - Country:US
Mailing Address - Phone:678-832-5736
Mailing Address - Fax:
Practice Address - Street 1:5918 APPALOOSA WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-4213
Practice Address - Country:US
Practice Address - Phone:678-832-5736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000340-P.A.363A00000X
FL11015129163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant