Provider Demographics
NPI:1629406400
Name:HOROVITZ, MAX AARON (PHD)
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:AARON
Last Name:HOROVITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6867 SOUTHPOINT DR N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8043
Mailing Address - Country:US
Mailing Address - Phone:904-619-6071
Mailing Address - Fax:904-212-0309
Practice Address - Street 1:10475 CENTURION PKWY N STE 301
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-5004
Practice Address - Country:US
Practice Address - Phone:904-308-3751
Practice Address - Fax:904-308-6890
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9132103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical