Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OT014242 | PA |
N | 111NI0900X | Internist | OT014242 | PA |
Y | 207RC0000X | Internist - Cardiovascular Disease | OS14455 | FL |
NPI | 1013201946 |
---|---|
Provider Name | Dr. Brian William Holyk |
First Address | Bradenton, FL 34205-8805 |
Second Address | Bradenton, FL 34205-8805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2011 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021231200 | (05) | FL |