Provider Demographics
NPI:1306164280
Name:HOLZWORTH, MARTHA JULIANA (DPM)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:JULIANA
Last Name:HOLZWORTH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:JULIANA
Other - Last Name:HUERTAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:660 GLADES RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6465
Mailing Address - Country:US
Mailing Address - Phone:561-602-1139
Mailing Address - Fax:561-634-4202
Practice Address - Street 1:650 GLADES RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6414
Practice Address - Country:US
Practice Address - Phone:561-602-1139
Practice Address - Fax:561-634-4202
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3595213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery