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General NPI Number Information
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NPI Number | 1679605430
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Entity Type | Organization
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Legal Business Name | HORIZON ALTAMONTE SPRINGS LLC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 745 ORIENTA AVE STE 1191
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6609
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Country | US
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Telephone | 407-617-9402
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 940536
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City | MAITLAND
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State | FL
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Zip | 32794-0536
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Country | US
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Telephone | 407-617-9402
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. SHARON NORMAN
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Credential |
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Telephone | 407-617-9402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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