Individual
DEREK M HOLMAN-HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
748 HARRISON AVE, PANAMA CITY, FL 32401-2524
(850) 763-4988
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(850) 763-4988
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108903
FL
363AM0700X
Medical Physician Assistant
PA9108903
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015685800
—
FL
Enumeration date
09/09/2015
Last updated
03/21/2025
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