Individual
WILLIAM HOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114
(386) 238-3200
Mailing address
PO BOX 9671, DAYTONA BEACH, FL 32120
(386) 615-4015
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME25392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300067505
RAILROAD MEDICARE
FL
01
—
ME25392
UNITED BENEFITS
FL
Enumeration date
03/08/2006
Last updated
02/23/2011
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