MEDICARE: DR. GINA V. HORNE D.O.

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	207R00000X	Internal Medicine Physician	34.009476	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	4266331	OTHER	OH	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881714301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GINA V. HORNE D.O.

Provider Business Mailing Address
First Line	:	5901 E ROYALTON RD STE 2200
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-3532
Country	:	US
Telephone Number	:	440-838-8222
Fax Number	:	440-838-8294

Provider Business Practice Location Address
First Line	:	5901 E ROYALTON RD STE 2200
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-3532
Country	:	US
Telephone Number	:	440-838-8222
Fax Number	:	440-838-8294

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	12/18/2020

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Directions to “ DR. GINA V. HORNE D.O.” Practice Location

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