Provider Demographics
NPI:1417698671
Name:HOLLAND JR, FLOYD L B (CRNA)
Entity type:Individual
Prefix:MR
First Name:FLOYD
Middle Name:L B
Last Name:HOLLAND JR
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9415 ALBANY CT
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5635
Mailing Address - Country:US
Mailing Address - Phone:708-364-7208
Mailing Address - Fax:708-949-8873
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-8000
Practice Address - Fax:708-684-1028
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-03
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.030083367500000X
IN28211665A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered