Provider Demographics
NPI:1356528368
Name:HORWITZ, JEFFREY CRAIG (PT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CRAIG
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 NW 9TH AVE
Mailing Address - Street 2:SUITE 1207
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-5943
Mailing Address - Country:US
Mailing Address - Phone:954-390-7245
Mailing Address - Fax:954-390-6167
Practice Address - Street 1:3405 NW 9TH AVE
Practice Address - Street 2:SUITE 1207
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-5943
Practice Address - Country:US
Practice Address - Phone:954-390-7245
Practice Address - Fax:954-390-6167
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0226AMedicare UPIN