Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME73391 | FL |
Y | 208600000X | Surgeon | ME73391 | FL |
NPI | 1023102886 |
---|---|
Provider Name | Daniel T Holley |
First Address | Stuart, FL 34994 |
Second Address | Stuart, FL 34994 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 02/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005673558 | AETNA (01) | FL |
240006528 | RAILROAD MEDICARE (01) | FL |
41373 | BC BS OF FLORIDA (01) | FL |
650921418 | FIRST HEALTH (01) | FL |
650921418 | ONE SOURCE HEALTH NETWORK (01) | FL |
650921418 | PHCS (01) | FL |
650921418 | TRICARE (01) | FL |
650921418 | WEB TPA (01) | FL |
720838 | CIGNA (01) | FL |
F32198 | (02) | FL |