Provider Demographics
NPI:1215905120
Name:DAGNEY, HOLLY D (DO)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:D
Last Name:DAGNEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 COLLIER BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-3589
Mailing Address - Country:US
Mailing Address - Phone:239-348-4538
Mailing Address - Fax:239-348-4553
Practice Address - Street 1:8340 COLLIER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3589
Practice Address - Country:US
Practice Address - Phone:239-348-4538
Practice Address - Fax:239-348-4553
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13683207Q00000X
IN02001178A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INE85802Medicare UPIN
IN110044389Medicare PIN
IN1224690001Medicare NSC
IN1224690001Medicare NSC