Healthcare Provider Details
I. General information
NPI: 1124131164
Provider Name (Legal Business Name): EDWARD HORVATH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/16/2006
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7270 W BOYNTON BEACH BLVD SUITE 102
BOYNTON BEACH FL
33437-3802
US
IV. Provider business mailing address
PO BOX 740177
BOYNTON BEACH FL
33474-0177
US
V. Phone/Fax
- Phone: 561-738-5772
- Fax: 561-738-0096
- Phone: 561-740-2900
- Fax: 561-434-0598
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | ME94891 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: