Individual
HOLLY BLICKENSTAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
109 MARGARET ST, BRANDON, FL 33511-5203
(813) 654-2544
Mailing address
109 MARGARET ST, BRANDON, FL 33511-5203
(813) 654-2544
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/17/2025
Last updated
10/15/2025
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