Provider Demographics
NPI:1811107303
Name:HORVATH, KOMAL MARK (DO)
Entity type:Individual
Prefix:DR
First Name:KOMAL
Middle Name:MARK
Last Name:HORVATH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6900 NW 9TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605
Mailing Address - Country:US
Mailing Address - Phone:352-333-6680
Mailing Address - Fax:352-331-4006
Practice Address - Street 1:6900 NW 9TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4251
Practice Address - Country:US
Practice Address - Phone:352-333-6680
Practice Address - Fax:352-331-4006
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013916207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2827788OtherUNITED HEALTH CARE
PA17413OtherELDER CARE
PA2850091001OtherKEYSTONE
PA1969274OtherBLUE SHIELD
PA1561533OtherAETNA
PA2827788OtherUNITED HEALTH CARE