Individual
THERESA HORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
949 NE MAPLE LN, LAKE CITY, FL 32055-3577
(386) 292-9355
Mailing address
949 NE MAPLE LN, LAKE CITY, FL 32055-3577
(386) 292-9355
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92-1097270
—
FL
Enumeration date
02/10/2023
Last updated
02/10/2023
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