MEDICARE: HOLO WELLSPRING

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1366394884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLO WELLSPRING

Provider Business Mailing Address
First Line	:	1413 S PATRICK DR STE 3
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-4374
Country	:	US
Telephone Number	:	321-432-5550
Fax Number	:

Provider Business Practice Location Address
First Line	:	1413 S PATRICK DR STE 3
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-4374
Country	:	US
Telephone Number	:	321-432-5550
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CRYSTAL TURMAN
Credential	:	LCSW
Telephone Number	:	321-432-5550

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “HOLO WELLSPRING ” Practice Location

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