Provider Demographics
NPI:1346523107
Name:HOLCOMB, DARRYL E (RPH)
Entity type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:E
Last Name:HOLCOMB
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 KUHL AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1127
Mailing Address - Country:US
Mailing Address - Phone:407-849-5088
Mailing Address - Fax:407-849-3094
Practice Address - Street 1:1200 KUHL AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1127
Practice Address - Country:US
Practice Address - Phone:407-849-5088
Practice Address - Fax:407-849-3094
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS21348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist