Provider Demographics
NPI:1568738714
Name:HORODECK, HARRY G (RPH)
Entity Type:Individual
Prefix:MR
First Name:HARRY
Middle Name:G
Last Name:HORODECK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 NW 8TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-5734
Mailing Address - Country:US
Mailing Address - Phone:239-989-9490
Mailing Address - Fax:
Practice Address - Street 1:2636 NW 8TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-5734
Practice Address - Country:US
Practice Address - Phone:239-989-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0012646183500000X
FLPU003519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist