Healthcare Provider Details

I. General information

NPI: 1104730720
Provider Name (Legal Business Name): HOLMES REGIONAL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 HICKORY ST
MELBOURNE FL
32901-3223
US

IV. Provider business mailing address

PO BOX 749206
ATLANTA GA
30374-9206
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-9133
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL

VIII. Authorized Official

Name: KRISTEN PULIO
Title or Position: EVP CFO
Credential:
Phone: 321-434-5606