Provider Demographics
NPI:1528141405
Name:HOLZMACHER, JOSEPH CRAIG (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CRAIG
Last Name:HOLZMACHER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E MURIEL ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3030
Mailing Address - Country:US
Mailing Address - Phone:321-230-0546
Mailing Address - Fax:407-841-1655
Practice Address - Street 1:124 E MURIEL ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3030
Practice Address - Country:US
Practice Address - Phone:321-230-0546
Practice Address - Fax:407-841-1655
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4661103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73881OtherBC/BS
FL73881OtherBC/BS
FLOTH000Medicare UPIN