Provider Demographics
NPI:1083453575
Name:HORINKA, SAMUEL COLE
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:COLE
Last Name:HORINKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 VANDERBILT DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-6031
Mailing Address - Country:US
Mailing Address - Phone:386-627-9238
Mailing Address - Fax:
Practice Address - Street 1:1260 VANDERBILT DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6031
Practice Address - Country:US
Practice Address - Phone:386-627-9238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications