MEDICARE: HORIZON RELAY SERVICES

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1710716212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON RELAY SERVICES

Provider Business Mailing Address
First Line	:	10163 FORTUNE PKWY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6757
Country	:	US
Telephone Number	:	904-868-8348
Fax Number	:	904-850-6764

Provider Business Practice Location Address
First Line	:	10163 FORTUNE PKWY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6757
Country	:	US
Telephone Number	:	904-868-8348
Fax Number	:	904-850-6764

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINA SONY'A DAWSEY
Credential	:
Telephone Number	:	904-868-8348

Provider Enumeration Date	:	08/01/2024
Last Update Date	:	10/25/2024

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