Individual
SHELLY WELCH HOLMSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4503 N 22ND ST, TAMPA, FL 33610-6201
(813) 738-6684
(813) 413-8549
Mailing address
1410 HARBOUR WALK RD, TAMPA, FL 33602-5971
(813) 394-1668
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME90448
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270375100
—
FL
01
—
48546
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/14/2006
Last updated
10/25/2023
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