Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | ME58193 | FL |
NPI | 1538109137 |
---|---|
Provider Name | Robert W Holloway |
First Address | Orlando, FL 32804-4603 |
Second Address | Orlando, FL 32804-4603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 07/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
064300900 | (05) | FL |
10886 | BCBS (01) | FL |
830002205 | RAILROAD MEDICARE (01) | |
C74826 | (02) |