Provider Demographics
NPI:1295978260
Name:HORST, INDIRA B (MD)
Entity type:Individual
Prefix:
First Name:INDIRA
Middle Name:B
Last Name:HORST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:INDIRA
Other - Middle Name:BOLANO
Other - Last Name:HORST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6250 SW 79TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4930
Mailing Address - Country:US
Mailing Address - Phone:786-899-0383
Mailing Address - Fax:786-803-8927
Practice Address - Street 1:7700 N KENDALL DR STE 307
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7559
Practice Address - Country:US
Practice Address - Phone:786-899-0383
Practice Address - Fax:786-803-8926
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1223882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20151123005592Medicare UPIN