Basic Information
| Provider Information | |||||||||
| NPI: | 1710114848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HORST | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4185 MOSSY COVE CT | ||||||||
| Address2: | |||||||||
| City: | NICEVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325787146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8508308638 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 MAR WALT DR | ||||||||
| Address2: | FORT WALTON BEACH MED CENTER | ||||||||
| City: | FORT WALTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325471302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8508637660 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 05/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | ME114573 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.