Healthcare Provider Details

I. General information

NPI: 1164352340
Provider Name (Legal Business Name): JORDAN HORWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3823 FL-64
BRADENTON FL
34208
US

IV. Provider business mailing address

3823 FL-64
BRADENTON FL
34208
US

V. Phone/Fax

Practice location:
  • Phone: 941-745-5111
  • Fax: 404-216-4868
Mailing address:
  • Phone: 941-745-5111
  • Fax: 404-216-4868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: