Individual
MAUREEN CLAIRE HOLASEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1920 DON WICKHAM DR, STE. 130, CLERMONT, FL 34711-1918
(352) 243-9709
(352) 243-8703
Mailing address
PO BOX 864460, ORLANDO, FL 32886-0001
(352) 243-9709
(352) 243-8703
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME62103
FL
2085R0001X
Radiation Oncology Physician
Primary
ME62103
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15050
BCBS
FL
01
—
212921
AVMED
FL
05
—
370683400
—
FL
01
—
P00470573
RR MEDICARE
FL
Enumeration date
06/23/2005
Last updated
06/03/2015
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