Individual
TAVIOUS HOLLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 SARNO ROAD, SUITE 119J, MELBOURNE, FL 32935
(321) 345-7832
Mailing address
1600 SARNO ROAD, SUITE 119J, MELBOURNE, FL 32935
(321) 345-7832
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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