Provider Demographics
NPI:1568621423
Name:HORTON, GERALD FREDERICK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:FREDERICK
Last Name:HORTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6101 LAKE ELLENOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4616
Mailing Address - Country:US
Mailing Address - Phone:407-858-1400
Mailing Address - Fax:407-858-5518
Practice Address - Street 1:5655 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4289
Practice Address - Country:US
Practice Address - Phone:407-888-1330
Practice Address - Fax:407-858-5518
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2012-12-19
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Provider Licenses
StateLicense IDTaxonomies
FLME44604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001558600Medicaid
FL001558600Medicaid
D21385Medicare UPIN