Provider Demographics
NPI:1962452375
Name:HORSCHEL, REBECCA J (ARNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:HORSCHEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3466 N HARBOR CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5713
Mailing Address - Country:US
Mailing Address - Phone:321-242-8790
Mailing Address - Fax:321-242-1541
Practice Address - Street 1:7125 MURRELL RD
Practice Address - Street 2:SUITE E
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7999
Practice Address - Country:US
Practice Address - Phone:321-242-8790
Practice Address - Fax:321-242-1541
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP672722363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY5492XMedicare PIN
FLS20205Medicare UPIN
FLY5492XMedicare PIN