Healthcare Provider Details

I. General information

NPI: 1487076451
Provider Name (Legal Business Name): HORIZON PALLIATIVE CARE PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1961 IOWA AVE NE
ST PETERSBURG FL
33703-3425
US

IV. Provider business mailing address

1961 IOWA AVE NE
ST PETERSBURG FL
33703-3425
US

V. Phone/Fax

Practice location:
  • Phone: 813-476-1515
  • Fax:
Mailing address:
  • Phone: 813-476-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME92933
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME85711
License Number StateFL

VIII. Authorized Official

Name: DR. ALEXANDRA S OWENS
Title or Position: PRESIDENT
Credential: MD
Phone: 813-476-1515