Individual
MR. JONATHAN MAKYLE HOLTZCLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Mailing address
21809 93RD DR, O BRIEN, FL 32071-2601
(386) 243-1054
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5194216
FL
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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