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1356487896

NPI Code Detail

MEDICARE: HOLLY MARIE MAGIERA MD

MEDICARE: HOLLY MARIE MAGIERA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	2004007042	MO
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	ME98175	FL
3	208M00000X	Hospitalist Physician	2004007042	MO
4	207R00000X	Internal Medicine Physician	ME98175	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356487896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY MARIE MAGIERA MD

Provider Business Mailing Address
First Line	:	555 STOCKTON ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-2534
Country	:	US
Telephone Number	:	904-387-4661
Fax Number	:	904-388-4578

Provider Business Practice Location Address
First Line	:	555 STOCKTON ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-2534
Country	:	US
Telephone Number	:	904-387-4661
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	06/28/2021

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Directions to “ HOLLY MARIE MAGIERA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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