Healthcare Provider Details

I. General information

NPI: 1982551081
Provider Name (Legal Business Name): DAVIANA HOLLIMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 PURYEAR STREET, ST. AUGUSTINE, FL, USA
ST. AUGUSTINE FL
32084
US

IV. Provider business mailing address

924 PURYEAR STREET, ST. AUGUSTINE, FL, USA
ST. AUGUSTINE FL
32084
US

V. Phone/Fax

Practice location:
  • Phone: 904-479-8998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: