Provider Demographics
NPI:1548285893
Name:HENLEY-SEYMOUR, ANDREA RHONEA (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:RHONEA
Last Name:HENLEY-SEYMOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:RHONEA
Other - Last Name:HENLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11581 NW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2033
Mailing Address - Country:US
Mailing Address - Phone:770-880-6514
Mailing Address - Fax:
Practice Address - Street 1:11581 NW 24TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33323-2033
Practice Address - Country:US
Practice Address - Phone:770-880-6514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97055208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I62536Medicare UPIN
AL6092Medicare PIN