MEDICARE: ETHEL HOLDER PA

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	363A00000X	Physician Assistant	PA9109641	FL
2	363A00000X	Physician Assistant	009214	NY

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	:	1396889127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ETHEL HOLDER PA

Provider Business Mailing Address
First Line	:	425 W COLONIAL DR STE 303
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	407-382-1376
Fax Number	:	833-450-5418

Provider Business Practice Location Address
First Line	:	1130 S SEMORAN BLVD STE B-C
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-1457
Country	:	US
Telephone Number	:	407-382-1376
Fax Number	:	833-450-5418

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	03/18/2026

Similar Medicare Providers

1871591529 — DR. JAMES DOUGLAS FINNIE DC
Practice Location Address:

1130 S SEMORAN BLVD , SUITE E
ORLANDO, FL
32807-1457

Practice Phone: 407-277-3535
Practice Fax: 407-277-6060

1306836234 — ROSA M PACHECO MD
Practice Location Address:

1130 S SEMORAN BLVD
ORLANDO, FL
32807-1457

Practice Phone: 407-382-1376
Practice Fax: 321-235-3232

1922083948 — JESUS RAFAEL PICHARDO MD
Practice Location Address:

1130 S SEMORAN BLVD
ORLANDO, FL
32807-1457

Practice Phone: 407-382-1376
Practice Fax: 321-235-3232

1639374200 — FINNIE CHIROPRACTIC CENTER LLC
Practice Location Address:

1130 S SEMORAN BLVD , SUITE E
ORLANDO, FL
32807-1457

Practice Phone: 407-277-3535
Practice Fax: 407-277-6060

1184935900 — DR. WILLMA L PADRO M.D.
Practice Location Address:

1130 S SEMORAN BLVD , STE. B
ORLANDO, FL
32807-1457

Practice Phone: 650-279-9703
Practice Fax:

1164726667 — DR. CARLOS S DIAZ BARCELO M.D.
Practice Location Address:

1130 S SEMORAN BLVD
ORLANDO, FL
32807-1457

Practice Phone: 407-382-1376
Practice Fax: 321-235-3232

Directions to “ ETHEL HOLDER PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.