Individual
MRS. HOLLY ANN LOEBL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
258 S CHICKASAW TRL STE 200, ORLANDO, FL 32825-3501
(407) 303-6865
(407) 303-6537
Mailing address
258 S CHICKASAW TRL STE 200, ORLANDO, FL 32825-3501
(407) 303-6865
(407) 303-6537
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102707
FL
363AM0700X
Medical Physician Assistant
PA9102707
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292856600
—
FL
01
—
391595
WELLCARE
FL
Enumeration date
10/11/2005
Last updated
09/01/2020
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