MEDICARE: HOLAMER INC

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	174400000X	Specialist	MM9016	FL

General Provider Information

NPI Number	:	1568684843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLAMER INC

Provider Business Mailing Address
First Line	:	1915 NE 45TH STREET
Second Line	:	#103
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5100
Country	:	US
Telephone Number	:	954-491-6158
Fax Number	:	954-491-6158

Provider Business Practice Location Address
First Line	:	1915 NE 45TH STREET
Second Line	:	#103
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5100
Country	:	US
Telephone Number	:	954-491-6158
Fax Number	:	954-491-6158

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL JAMES ROWLANDS
Credential	:	LMT
Telephone Number	:	954-491-6158

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/12/2008

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