Provider Demographics
NPI:1578701744
Name:HENRIQUEZ, ISRAEL E (DO)
Entity Type:Individual
Prefix:DR
First Name:ISRAEL
Middle Name:E
Last Name:HENRIQUEZ
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:PO BOX 1057
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1057
Mailing Address - Country:US
Mailing Address - Phone:561-753-0001
Mailing Address - Fax:561-753-0005
Practice Address - Street 1:1447 MEDICAL PARK BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3164
Practice Address - Country:US
Practice Address - Phone:561-753-0001
Practice Address - Fax:561-753-0005
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS11160207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease