MEDICARE: RODNEY O. HORTON O.D.

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	152W00000X	Optometrist	OPC0001586	FL

General Provider Information

NPI Number	:	1578588224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY O. HORTON O.D.

Provider Business Mailing Address
First Line	:	5413 US HIGHWAY 19
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-3968
Country	:	US
Telephone Number	:	727-842-2020
Fax Number	:	727-847-9565

Provider Business Practice Location Address
First Line	:	5413 US HIGHWAY 19
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-3968
Country	:	US
Telephone Number	:	727-842-2020
Fax Number	:	727-847-9565

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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