Provider Demographics
NPI:1104951664
Name:HOROWITZ, MARK STUART (DPM)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:STUART
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7805 NW 5TH CT
Mailing Address - Street 2:48-206
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-4118
Mailing Address - Country:US
Mailing Address - Phone:954-394-4792
Mailing Address - Fax:
Practice Address - Street 1:7805 NW 5TH CT
Practice Address - Street 2:48-206
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4118
Practice Address - Country:US
Practice Address - Phone:954-394-4792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2111213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist