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Individual

DR. SIDNEY WAYNE HOLEC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
436 NOKOMIS AVE S, VENICE, FL 34285-2617
(941) 488-7742
(941) 484-7756
Mailing address
436 NOKOMIS AVE S, VENICE, FL 34285-2617
(941) 488-7742
(941) 484-7756

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
EO982
TX
208600000X
Surgery Physician
Primary
ME0022788
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020012689
RAILROAD MEDICARE
FL
01
04889
UNIVERSAL
FL
01
303424
UNITED HEALTH CARE GROUP MPIN
FL
01
59-1362995
GROUP TAX ID #
FL
01
7007140
CIGNA
FL
01
92415
BCBS
FL
Enumeration date
11/20/2006
Last updated
10/21/2008
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