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General NPI Number Information
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NPI Number | 1235198540
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Entity Type | Individual
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Provider Name | MONIQUE NICHOL HOLMES D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 5600 BAYSHORE RD
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City | PALMETTO
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State | FL
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Zip | 34221-9352
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Country | US
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Telephone | 941-708-7669
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Fax | 941-708-8893
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Provider Business Mailing Address
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Address Line | PO BOX 499
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City | PARRISH
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State | FL
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Zip | 34219-0499
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Country | US
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Telephone | 941-708-7669
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Fax | 941-708-8893
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO3111
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License Number State | FL
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