Individual
MS. TYRA MARIE HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2102 S DALE MABRY HWY, TAMPA, FL 33629-6335
(813) 798-1499
Mailing address
6301 S WEST SHORE BLVD APT 1321, TAMPA, FL 33616-1368
(707) 290-5860
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9116988
FL
Other
Enumeration date
02/15/2023
Last updated
03/30/2024
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