Provider Demographics
NPI:1912652314
Name:HORIZON CARE MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:HORIZON CARE MEDICAL CENTER, INC
Other - Org Name:HORIZON CARE MEDICAL CENTER, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:786-803-8002
Mailing Address - Street 1:1200 NW 78TH AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1816
Mailing Address - Country:US
Mailing Address - Phone:786-803-8002
Mailing Address - Fax:305-264-2909
Practice Address - Street 1:1200 NW 78TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1816
Practice Address - Country:US
Practice Address - Phone:786-803-0002
Practice Address - Fax:305-264-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site