Doctor Name: | DR. GARY G HOLLAND |
NPI Number: | 1225097074 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 0018048 |
Business Practice Address: | 10875 Park Blvd Ste A Seminole, FL - 337725456 |
Business Phone Number: | 7272922247 |
Business Fax Number: | 8773281192 |
Mailing Address: | 10875 Park Blvd, Ste A SEMINOLE |
State: | FL |
Postal Code: | 337725456 |
Phone Number: | 7272922247 |
Fax Number: | 8773281192 |
NPI Enumeration Date: | 03/21/2006 |
NPI Last Update Date: | 05/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0018048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |