Provider Demographics
NPI:1114115870
Name:HORIZONS PRIMARY CARE CENTER
Entity Type:Organization
Organization Name:HORIZONS PRIMARY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-658-3035
Mailing Address - Street 1:1755 HERITAGE TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-7591
Mailing Address - Country:US
Mailing Address - Phone:239-353-4101
Mailing Address - Fax:239-353-4231
Practice Address - Street 1:1755 HERITAGE TRL
Practice Address - Street 2:SUITE A
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-7591
Practice Address - Country:US
Practice Address - Phone:239-353-4101
Practice Address - Fax:239-353-4231
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLLIER HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10-1946OtherMEDICARE FQHC PROVIDER NO