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General NPI Number Information
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NPI Number | 1588660658
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Entity Type | Individual
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Provider Name | MAUREEN CLAIRE HOLASEK M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 1920 DON WICKHAM DR STE. 130
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City | CLERMONT
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State | FL
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Zip | 34711-1918
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Country | US
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Telephone | 352-243-9709
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Fax | 352-243-8703
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Provider Business Mailing Address
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Address Line | PO BOX 864460
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City | ORLANDO
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State | FL
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Zip | 32886-0001
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Country | US
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Telephone | 352-243-9709
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Fax | 352-243-8703
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME62103
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME62103
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License Number State | FL
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