Healthcare Provider Details

I. General information

NPI: 1720652712
Provider Name (Legal Business Name): HOLLY ELIZABETH HALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14150 SW 136TH ST
MIAMI FL
33186-5506
US

IV. Provider business mailing address

14150 SW 136TH ST
MIAMI FL
33186-5506
US

V. Phone/Fax

Practice location:
  • Phone: 786-888-8820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME184293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: