Healthcare Provider Details

I. General information

NPI: 1902239601
Provider Name (Legal Business Name): KRISTA HORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9611 W BROWARD BLVD
PLANTATION FL
33324-2334
US

IV. Provider business mailing address

4278 28TH ST N
ST PETERSBURG FL
33714-3922
US

V. Phone/Fax

Practice location:
  • Phone: 954-924-7000
  • Fax:
Mailing address:
  • Phone: 727-526-9135
  • Fax: 727-526-4346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9363563
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9363563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: