Provider Demographics
NPI:1962803346
Name:HORIZON SPEECH LANGUAGE THERAPY INC.
Entity type:Organization
Organization Name:HORIZON SPEECH LANGUAGE THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:FONTAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS SLP
Authorized Official - Phone:646-353-8513
Mailing Address - Street 1:5001 COLLINS AVE
Mailing Address - Street 2:APT 8C
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2741
Mailing Address - Country:US
Mailing Address - Phone:646-353-8513
Mailing Address - Fax:786-453-2042
Practice Address - Street 1:5001 COLLINS AVE
Practice Address - Street 2:APT 8C
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2741
Practice Address - Country:US
Practice Address - Phone:646-353-8513
Practice Address - Fax:786-453-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11052235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008576700Medicaid