Provider Demographics
NPI:1447630314
Name:HOROWITZ, IRVING ISAAC (PTA)
Entity type:Individual
Prefix:MR
First Name:IRVING
Middle Name:ISAAC
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 CORAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2354
Mailing Address - Country:US
Mailing Address - Phone:954-461-8358
Mailing Address - Fax:954-757-1739
Practice Address - Street 1:4275 CORAL SPRINGS DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2354
Practice Address - Country:US
Practice Address - Phone:954-461-8358
Practice Address - Fax:954-757-1739
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA3225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant