Provider Demographics
NPI:1992919351
Name:HORVAT, BRANIMIR L (MD)
Entity type:Individual
Prefix:DR
First Name:BRANIMIR
Middle Name:L
Last Name:HORVAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3333 CLARK RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8432
Mailing Address - Country:US
Mailing Address - Phone:941-923-1809
Mailing Address - Fax:941-927-9645
Practice Address - Street 1:3333 CLARK RD
Practice Address - Street 2:SUITE 160
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8432
Practice Address - Country:US
Practice Address - Phone:941-923-1809
Practice Address - Fax:941-927-9645
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0029671207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD32511Medicare UPIN
FL58355Medicare PIN