Healthcare Provider Details
I. General information
NPI: 1154305571
Provider Name (Legal Business Name): FRANCIS JOHN HORNICEK JR. MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/30/2005
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1475 NW 12TH AVE FL 3
MIAMI FL
33136-1002
US
IV. Provider business mailing address
1120 NW 14TH ST STE 1263Z
MIAMI FL
33136-2107
US
V. Phone/Fax
- Phone: 305-243-3208
- Fax: 305-243-0337
- Phone: 305-302-1783
- Fax: 305-243-0337
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 150718 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | G148755 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | ME68816 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: