Healthcare Provider Details

I. General information

NPI: 1720476534
Provider Name (Legal Business Name): HOLLY DAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2014
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2552 NE TURNER AVE LOT 25
ARCADIA FL
34266-5905
US

IV. Provider business mailing address

2552 NE TURNER AVE LOT 25
ARCADIA FL
34266-5905
US

V. Phone/Fax

Practice location:
  • Phone: 850-890-3531
  • Fax:
Mailing address:
  • Phone: 850-890-3531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA59456
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: