Individual
DANIEL HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
237 FERNWOOD BLVD, FERN PARK, FL 32730-2116
(407) 831-2411
(407) 831-6760
Mailing address
1505 NORTHLAKE DR, SANFORD, FL 32773-6178
(407) 221-0532
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN5166644
FL
2084P0800X
Psychiatry Physician
Primary
PN5166644
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164581633
—
FL
Enumeration date
10/04/2007
Last updated
10/19/2007
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