Healthcare Provider Details

I. General information

NPI: 1306541743
Provider Name (Legal Business Name): ASHLEY HOLLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 SW 75TH ST
GAINESVILLE FL
32607-5376
US

IV. Provider business mailing address

5441 DELONA RD
MILTON FL
32583-1612
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-0085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME179671
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: