Provider Demographics
NPI:1508243478
Name:HORIZON MEDICAL AND AESTHETIC CENTER
Entity Type:Organization
Organization Name:HORIZON MEDICAL AND AESTHETIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:LLANES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-320-9747
Mailing Address - Street 1:5366 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2746
Mailing Address - Country:US
Mailing Address - Phone:305-320-9747
Mailing Address - Fax:
Practice Address - Street 1:5366 PALM AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2746
Practice Address - Country:US
Practice Address - Phone:305-320-9747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center