Provider Demographics
NPI:1043358823
Name:HOROWITZ, MARK ABRAHAM (OD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ABRAHAM
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 S FEDERAL HWY
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3329
Mailing Address - Country:US
Mailing Address - Phone:561-276-5099
Mailing Address - Fax:561-274-9697
Practice Address - Street 1:1715 S FEDERAL HWY
Practice Address - Street 2:SUITE C-1
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3329
Practice Address - Country:US
Practice Address - Phone:561-276-5099
Practice Address - Fax:561-274-9697
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1155152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL084869900Medicaid
FL19644Medicare PIN
FL084869900Medicaid