Provider Demographics
NPI:1962173245
Name:HOLT, ASHLEE LYNN (RPH)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:LYNN
Last Name:HOLT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 N JOHN YOUNG PKWY APT 3
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-2235
Mailing Address - Country:US
Mailing Address - Phone:772-475-4462
Mailing Address - Fax:
Practice Address - Street 1:4905 E IRLO BRONSON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8724
Practice Address - Country:US
Practice Address - Phone:407-891-8371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist