Organization
HOLLI-STARR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN VALENZUELA ESTARES (ADMINSTRATOR)
(850) 384-7656
Entity
Organization
Contact information
Practice address
3075 PARTRIDGE DR, PENSACOLA, FL 32526-3607
(850) 384-7656
Mailing address
3075 PARTRIDGE DR, PENSACOLA, FL 32526-3607
(850) 384-7656
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
6906454
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003088100
—
FL
Enumeration date
02/24/2014
Last updated
02/24/2014
Update your record
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