Provider Demographics
NPI:1659892321
Name:NORMA HENRIQUEZ PL
Entity Type:Organization
Organization Name:NORMA HENRIQUEZ PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-400-9022
Mailing Address - Street 1:10201 ARCOS AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-9461
Mailing Address - Country:US
Mailing Address - Phone:239-400-9022
Mailing Address - Fax:855-225-4662
Practice Address - Street 1:10201 ARCOS AVE STE 201
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9461
Practice Address - Country:US
Practice Address - Phone:239-400-9022
Practice Address - Fax:855-225-4662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty