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Individual

DR. STEPHANIE DYANE HOLLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
315 S OCEAN GRANDE DR, UNIT 103, PONTE VEDRA BEACH, FL 32082-4599
(904) 315-8765
(904) 827-0485
Mailing address
851 TRAFALGAR CT., SUITE 200E, MAITLAND, FL 32751
(407) 667-0444
(407) 667-4338

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME90482
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269914100
FL
Enumeration date
08/25/2006
Last updated
07/21/2017
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