MEDICARE: HOLLY A SHEETS DPM 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	213E00000X	Podiatrist	PO2661	FL

General Provider Information

NPI Number	:	1639175235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLY A SHEETS DPM PA

Provider Business Mailing Address
First Line	:	PO BOX 1962
Second Line	:
City	:	PALATKA
State	:	FL
Zip	:	32178-1962
Country	:	US
Telephone Number	:	386-326-3553
Fax Number	:	386-326-3919

Provider Business Practice Location Address
First Line	:	800 ZEAGLER DR
Second Line	:	STE 510
City	:	PALATKA
State	:	FL
Zip	:	32177-3867
Country	:	US
Telephone Number	:	386-326-3553
Fax Number	:	386-326-3919

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. HOLLY A SHEETS
Credential	:	DPM
Telephone Number	:	386-326-3553

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/22/2020

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