Provider Demographics
NPI:1710114848
Name:HORST, REBECCA A (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:HORST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4185 MOSSY COVE CT
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-7146
Mailing Address - Country:US
Mailing Address - Phone:850-830-8638
Mailing Address - Fax:
Practice Address - Street 1:1100 MAR WALT DR
Practice Address - Street 2:FORT WALTON BEACH MED CENTER
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1302
Practice Address - Country:US
Practice Address - Phone:850-863-7660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114573207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine