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General NPI Number Information
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NPI Number | 1174377303
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Entity Type | Individual
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Provider Name | HAYLEE NICOLE HOLLIS MAT, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 10393 SEIDEL RD
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City | WINTER GARDEN
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State | FL
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Zip | 34787-6559
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Country | US
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Telephone | 407-554-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 800 MAGUIRE PARK ST APT 201
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City | OCOEE
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State | FL
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Zip | 34761-4931
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Country | US
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Telephone | 407-687-8278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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