Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1578527305 Deactivated / Inactive NPI Female Practitioner

Dr. Tabitha Anne Henderson , MD

Dermatology • Cocoa, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Tabitha Henderson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 17, 2006
NPI Deactivation Date September 22, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Tabitha Henderson, MD was a registered Dermatology practicing in Cocoa, FL. Throughout an active medical career spanning 14 years, Dr. Henderson provided care at the practice location at 4260 N US HIGHWAY 1 until profile deactivation on 2020-09-22.

Practice Location & Contact Primary Location

Practice Address

4260 N Us Highway 1

Cocoa, FL 329275919

Telephone 3217681600
Fax 3214333792
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Cocoa, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 23.7 Yrs
Regional Practice Density
2 Specialists

Practicing in Cocoa, FL (1273 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License FL ME87529

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Jeanette Gluck , PA-C

Physician Assistant

NPI 1023072170

Physician Assistant (Certified)

Nichole Palomba , PA-C

Physician Assistant

NPI 1124494661

Physician Assistant (Certified)

Dr. Ruben Moreno , MD

Dermatology - MOHS-Micrographic Surgery

NPI 1225092331

Doctor of Medicine (M.D.)

Maria Fortington , PA-C

Physician Assistant

NPI 1265428288

Physician Assistant (Certified)

Anthony Moreno , PA-C

Physician Assistant - Medical

NPI 1356909964

Physician Assistant (Certified)

Johanna Espenschied , PA-C

Physician Assistant - Medical

NPI 1427474584

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 22, 2020

Record deactivated on September 22, 2020

NPI Profile Active December 21, 2012

NPI status registered as active in NPPES database

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Updated Practice Location December 21, 2012

Registered at 4260 N US HIGHWAY 1, COCOA, FL 329275919 (Tel: 3217681600)

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Updated Business Mailing Address December 21, 2012

Registered at 5070 MINTON RD NW, SUITE 3A, PALM BAY, FL 329071157 (Tel: 3217992840)

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Provider Name / Credentials Updated December 21, 2012

Recorded as TABITHA HENDERSON, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 21, 2012

Dermatology (License #ME87529 in FL)

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Initial NPI Registration & Enumeration April 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578527305
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 17, 2006
Last Update: December 21, 2012
Deactivation Date: September 22, 2020

Mailing Address

5070 Minton Rd Nw, Suite 3a

Palm Bay, FL 329071157

Phone: 3217992840

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.