MEDICARE: MRS. PATRICIA A. HOLT LMHC

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	101YM0800X	Mental Health Counselor	MH1128	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1578546289	OTHER	FL	ENTITY NPI

General Provider Information

NPI Number	:	1528264413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA A. HOLT LMHC

Provider Business Mailing Address
First Line	:	1340 ASTURIA AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4738
Country	:	US
Telephone Number	:	395-807-9796
Fax Number	:	305-441-1147

Provider Business Practice Location Address
First Line	:	3692 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3033
Country	:	US
Telephone Number	:	305-441-6657
Fax Number	:	305-441-1147

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

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	07/08/2007

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