Healthcare Provider Details

I. General information

NPI: 1912652314
Provider Name (Legal Business Name): HORIZON CARE MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NW 78TH AVE STE 105
DORAL FL
33126-1816
US

IV. Provider business mailing address

1200 NW 78TH AVE STE 105
DORAL FL
33126-1816
US

V. Phone/Fax

Practice location:
  • Phone: 786-803-0002
  • Fax: 305-264-2909
Mailing address:
  • Phone: 786-803-8002
  • Fax: 305-264-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: ALFREDO MARTIN
Title or Position: CEO
Credential: RN BSN
Phone: 786-803-8002