Provider Demographics
NPI:1679853345
Name:HORNE, CONNIE (DO)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2025 INDIAN ROCKS RD S
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-1035
Mailing Address - Country:US
Mailing Address - Phone:727-586-7103
Mailing Address - Fax:727-585-7205
Practice Address - Street 1:3600 OAK MANOR LN APT 46
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-1214
Practice Address - Country:US
Practice Address - Phone:727-489-3305
Practice Address - Fax:727-499-9559
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLUO2813207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine