MEDICARE: LARRY WAYNE HORTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	ME61926	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AL246	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023092681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY WAYNE HORTON MD

Provider Business Mailing Address
First Line	:	4140 WOODLANDS PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3494
Country	:	US
Telephone Number	:	727-953-9041
Fax Number	:	727-953-9043

Provider Business Practice Location Address
First Line	:	4140 WOODLANDS PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3494
Country	:	US
Telephone Number	:	727-953-9041
Fax Number	:	727-953-9043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	05/05/2020

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Directions to “ LARRY WAYNE HORTON MD” Practice Location

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