MEDICARE: NEW HORIZONS 2011, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	344600000X	Taxi

General Provider Information

NPI Number	:	1043587447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZONS 2011, LLC

Provider Business Mailing Address
First Line	:	7 JUDY CT
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-3934
Country	:	US
Telephone Number	:	321-777-6851
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 JUDY CT
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-3934
Country	:	US
Telephone Number	:	321-777-6851
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MARIA B SHEARD
Credential	:
Telephone Number	:	321-777-6851

Provider Enumeration Date	:	11/30/2011
Last Update Date	:	11/30/2011

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