Healthcare Provider Details

I. General information

NPI: 1184128662
Provider Name (Legal Business Name): TONI SHYANN HORTON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONI SHYANN HORTON DO

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W 8TH ST
JACKSONVILLE FL
32209-6511
US

IV. Provider business mailing address

PO BOX 44008
JACKSONVILLE FL
32231-4008
US

V. Phone/Fax

Practice location:
  • Phone: 904-383-1037
  • Fax: 904-244-4059
Mailing address:
  • Phone: 904-383-1037
  • Fax: 904-244-4059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberOS18913
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberOS18913
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: