Individual
MATTHEW HOLTHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1100
(863) 687-1192
Mailing address
5431 N RANGE WAY, BEVERLY HILLS, FL 34465-2150
(310) 748-4951
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9109699
FL
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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