Healthcare Provider Details

I. General information

NPI: 1326928912
Provider Name (Legal Business Name): DOLORES SLAVIN HOLLEMAN CME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3508 S ATLANTIC AVE
DAYTONA BEACH SHORES FL
32118-7639
US

IV. Provider business mailing address

5473 WARD LAKE DR
PORT ORANGE FL
32128-7476
US

V. Phone/Fax

Practice location:
  • Phone: 386-304-3411
  • Fax:
Mailing address:
  • Phone: 386-290-4017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberEO572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: