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Individual

MARTHA C HOLLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
12959 PALMS WEST DR, SUITE 210, LOXAHATCHEE, FL 33470-4937
(561) 795-3333
(561) 791-3002
Mailing address
12959 PALMS WEST DR, SUITE 210, LOXAHATCHEE, FL 33470-4937
(561) 795-3333
(561) 791-3002

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0024052901
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9269394
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010204011
VA
Enumeration date
11/02/2006
Last updated
09/06/2011
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