Healthcare Provider Details

I. General information

NPI: 1891893236
Provider Name (Legal Business Name): JAY HOROWITZ CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 US HIGHWAY 27 N
SEBRING FL
33870-1917
US

IV. Provider business mailing address

521 CUMMINGS ST
SARASOTA FL
34242-1308
US

V. Phone/Fax

Practice location:
  • Phone: 863-385-1544
  • Fax:
Mailing address:
  • Phone: 941-350-6118
  • Fax: 941-312-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN2699782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: