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Gwendolyn Young Henson

General Practice

Allopathic & Osteopathic Physicians

4700 N Habana Ave Ste 101, Tampa, FL 33614-7116

PECOS Enrollment

This provider is enrolled in PECOS as GWENDOLYN HENSON.

Based on the most recent information from CMS, provider Gwendolyn Young Henson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1700128832
Provider Type
Individual
Full Name
Henson, Gwendolyn Young
Credential
M.D.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/27/2013
Last Updated
3/29/2021

Contact Information

Practice Location

4700 N Habana Ave Ste 101, Tampa, FL 33614-7116

(407) 845-0330

(888) 972-1752

Mailing Location

6675 Westwood Blvd Ste 475, Orlando, FL 32821-6027

(407) 845-0330

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License ACN1313 Florida
Code 208D00000X	Description General Practice Allopathic & Osteopathic Physicians	License 20467 Puerto Rico

Gwendolyn Young Henson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Code

Description

License

Code

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License

Code

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