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General NPI Number Information
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NPI Number | 1710639521
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Entity Type | Individual
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Provider Name | HOLLEY S MOULING
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Gender | Female
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Dates
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Enumeration Date | 01/23/2022
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 1211 TECH BLVD
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City | TAMPA
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State | FL
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Zip | 33619-7846
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Country | US
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Telephone | 813-521-9546
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Fax |
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Provider Business Mailing Address
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Address Line | 422 W AMELIA AVE
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City | TAMPA
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State | FL
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Zip | 33602-1924
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Country | US
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Telephone | 813-521-9546
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | FL
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