Provider Demographics
NPI:1225052103
Name:VAN-HORNE, SIMONE (MD)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:VAN-HORNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10245 VESTAL CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5834
Mailing Address - Country:US
Mailing Address - Phone:954-470-2851
Mailing Address - Fax:855-667-5891
Practice Address - Street 1:2701 N COURSE DR APT 125
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3030
Practice Address - Country:US
Practice Address - Phone:954-470-2851
Practice Address - Fax:855-667-5891
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429595207R00000X
NY268075207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine