Healthcare Provider Details

I. General information

NPI: 1730806597
Provider Name (Legal Business Name): CRYSTAL POSTELL HORN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12325 NORTHLAKE BLVD UNIT 110
PALM BEACH GARDENS FL
33412-2767
US

IV. Provider business mailing address

611 SOUTHSHORE PT
MOUNT JULIET TN
37122-2664
US

V. Phone/Fax

Practice location:
  • Phone: 561-264-2490
  • Fax:
Mailing address:
  • Phone: 863-228-4204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6221
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: