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Organization
SUN CITY CENTER OPEN MRI
Active
Organization
SUN CITY CENTER OPEN MRI
Active
Parent organization
SIEGFRIED K HOLZ MD PA
Other names
SIEGFRIED K HOLZ MD PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIEGFRIED K HOLZ MD PA
Authorized official
DR. SIEGFRIED K HOLZ MD (PRESIDENT)
(863) 646-8955
Entity
Organization
Contact information
Practice address
725 CORTARO DR, RUSKIN, FL 33573-6812
(813) 642-0887
(813) 633-6527
Mailing address
3830 S FLORIDA AVE, LAKELAND, FL 33813-1105
(863) 646-8955
(863) 648-5216
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME40704
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376442
AETNA
FL
05
—
257741103
—
FL
01
—
V2920
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/06/2006
Last updated
12/04/2015
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