Provider Demographics
NPI:1699378745
Name:HORST, ERIN YORK (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:YORK
Last Name:HORST
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 87TH PL N APT 108
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-6226
Mailing Address - Country:US
Mailing Address - Phone:336-469-2263
Mailing Address - Fax:
Practice Address - Street 1:3420 TAMIAMI TRL UNIT 2
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8126
Practice Address - Country:US
Practice Address - Phone:941-629-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113648363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant