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General NPI Number Information
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NPI Number | 1306164280
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Entity Type | Individual
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Provider Name | MARTHA JULIANA HOLZWORTH DPM
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Gender | Female
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Dates
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Enumeration Date | 05/17/2010
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 650 GLADES RD
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City | BOCA RATON
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State | FL
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Zip | 33431-6414
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Country | US
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Telephone | 561-602-1139
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Fax | 561-634-4202
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Provider Business Mailing Address
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Address Line | 660 GLADES RD
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City | BOCA RATON
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State | FL
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Zip | 33431-6465
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Country | US
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Telephone | 561-602-1139
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Fax | 561-634-4202
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3595
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License Number State | FL
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