Provider Demographics
NPI:1134740061
Name:HORIZON FAMILY MEDICAL PRACTICE LLC
Entity type:Organization
Organization Name:HORIZON FAMILY MEDICAL PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VALEREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTHELEMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-774-8660
Mailing Address - Street 1:1236 ROYAL PALM BEACH BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1602
Mailing Address - Country:US
Mailing Address - Phone:561-774-8660
Mailing Address - Fax:561-774-8660
Practice Address - Street 1:1236 ROYAL PALM BEACH BLVD STE 108
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1602
Practice Address - Country:US
Practice Address - Phone:561-774-8660
Practice Address - Fax:561-774-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty