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General NPI Number Information
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NPI Number | 1518390384
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Entity Type | Individual
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Provider Name | ELLEN DARA HOLZ
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Gender | Female
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 15055 S JOG RD
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City | DELRAY BEACH
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State | FL
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Zip | 33446-1219
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Country | US
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Telephone | 561-496-0443
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Fax |
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Provider Business Mailing Address
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Address Line | 16372 CORVINO CT
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2327
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Country | US
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Telephone | 908-812-9435
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03579300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS51599
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License Number State | FL
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