Provider Demographics
NPI:1497370506
Name:HENRY, NATHAN (DO)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:HENRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:813-444-5838
Mailing Address - Fax:833-495-7206
Practice Address - Street 1:483 N SEMORAN BLVD STE 206
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3800
Practice Address - Country:US
Practice Address - Phone:407-678-2400
Practice Address - Fax:407-678-4926
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS19912207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine