Provider Demographics
NPI:1336532944
Name:HORESH, REMINGTON (DO)
Entity Type:Individual
Prefix:
First Name:REMINGTON
Middle Name:
Last Name:HORESH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9970 MOUNTAIN VIEW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-2476
Mailing Address - Country:US
Mailing Address - Phone:412-653-3080
Mailing Address - Fax:412-650-8860
Practice Address - Street 1:2955 BROWNWOOD BLVD STE 303
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2040
Practice Address - Country:US
Practice Address - Phone:523-508-4843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-07
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019844207WX0107X, 207W00000X
FLOS17421207W00000X
WV3504207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111733400Medicaid