Provider Demographics
NPI:1851763841
Name:HORIZON WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:HORIZON WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-947-3340
Mailing Address - Street 1:4000 S 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4307
Mailing Address - Country:US
Mailing Address - Phone:954-947-3340
Mailing Address - Fax:954-530-2644
Practice Address - Street 1:4000 S 57TH AVE
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4307
Practice Address - Country:US
Practice Address - Phone:954-947-3340
Practice Address - Fax:954-530-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78238207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty