MEDICARE: CYNTHIA D HOLCOMB

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	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1154979482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA D HOLCOMB

Provider Business Mailing Address
First Line	:	18115 PALM BEACH DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-4048
Country	:	US
Telephone Number	:	305-796-3336
Fax Number	:

Provider Business Practice Location Address
First Line	:	18115 PALM BEACH DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-4048
Country	:	US
Telephone Number	:	305-796-3336
Fax Number	:

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

Provider Enumeration Date	:	08/29/2019
Last Update Date	:	08/29/2019

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Directions to “ CYNTHIA D HOLCOMB ” Practice Location

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