Provider Demographics
NPI:1497729214
Name:HOROWITZ, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 WEST COLONIAL DR
Mailing Address - Street 2:STE 495
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3436
Mailing Address - Country:US
Mailing Address - Phone:407-293-5944
Mailing Address - Fax:407-293-7355
Practice Address - Street 1:10000 WEST COLONIAL DR
Practice Address - Street 2:STE 495
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3436
Practice Address - Country:US
Practice Address - Phone:407-293-5944
Practice Address - Fax:407-293-7355
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME648032086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CJ2327OtherRAILROAD MEDICARE
4512456OtherAETNA
020050264OtherCHAMPUS
178459OtherWELLCARE
23273OtherBLUE CROSS BLUE SHIELD
0970312019OtherCIGNA
F56080Medicare UPIN
4512456OtherAETNA