MEDICARE: DR. MARIA E HOLCOMB D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	OS4970	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023167608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA E HOLCOMB D.O.

Provider Business Mailing Address
First Line	:	6601 MEMORIAL HWY
Second Line	:	SUITE 320
City	:	TAMPA
State	:	FL
Zip	:	33615-4501
Country	:	US
Telephone Number	:	813-313-7535
Fax Number	:	813-243-2343

Provider Business Practice Location Address
First Line	:	6601 MEMORIAL HWY
Second Line	:	SUITE 320
City	:	TAMPA
State	:	FL
Zip	:	33615-4501
Country	:	US
Telephone Number	:	813-313-7535
Fax Number	:	813-243-2343

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	02/19/2014

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