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Individual

MARI SHELLY HOLDERBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
7912 FOREST CITY RD, ORLANDO, FL 32810-2907
(407) 905-8827
(321) 221-2047
Mailing address
110 S WOODLAND ST, WINTER GARDEN, FL 34787-3546
(407) 905-8827
(321) 221-2047

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4915
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012769900
FL
Enumeration date
07/14/2014
Last updated
04/28/2016
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