Healthcare Provider Details

I. General information

NPI: 1760948780
Provider Name (Legal Business Name): HOLLY CELLAMARE PA-C, RT (R)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HOLLY CHRISTINE SCHIEBL PA-C

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 MEADOWS RD STE 200
BOCA RATON FL
33486-2324
US

IV. Provider business mailing address

1001 NW 13TH ST STE 201
BOCA RATON FL
33486-2269
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-6784
  • Fax: 833-625-1611
Mailing address:
  • Phone: 561-955-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number548239
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number023890
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9118161
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: