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General NPI Number Information
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NPI Number | 1326938572
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Entity Type | Organization
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Legal Business Name | DR. HARDY'S HOLISTIC OASIS
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 2061 WESTBOROUGH LN
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City | KISSIMMEE
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State | FL
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Zip | 34746-7703
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Country | US
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Telephone | 414-324-7942
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Fax |
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Provider Business Mailing Address
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Address Line | 2061 WESTBOROUGH LN
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City | KISSIMMEE
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State | FL
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Zip | 34746-7703
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Country | US
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Telephone | 414-324-7942
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRINESE HARDY
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Credential |
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Telephone | 414-324-7942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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