Healthcare Provider Details

I. General information

NPI: 1447169743
Provider Name (Legal Business Name): HOLL STEEVE GABRIEL RCSWI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 WATERFORD DISTRICT DR
MIAMI FL
33126-7006
US

IV. Provider business mailing address

438 NE 210TH CIRCLE TER APT 2014B
MIAMI FL
33179-1854
US

V. Phone/Fax

Practice location:
  • Phone: 786-346-0632
  • Fax:
Mailing address:
  • Phone: 786-346-0632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22913
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: