Provider Demographics
NPI:1992871198
Name:HOLLY PHLEBOTOMY INC
Entity type:Organization
Organization Name:HOLLY PHLEBOTOMY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-625-3737
Mailing Address - Street 1:17311 SE 27TH PLACE RD
Mailing Address - Street 2:
Mailing Address - City:OCKLAWAHA
Mailing Address - State:FL
Mailing Address - Zip Code:32179-2356
Mailing Address - Country:US
Mailing Address - Phone:352-625-3737
Mailing Address - Fax:352-625-3737
Practice Address - Street 1:17311 SE 27TH PLACE RD
Practice Address - Street 2:
Practice Address - City:OCKLAWAHA
Practice Address - State:FL
Practice Address - Zip Code:32179-2356
Practice Address - Country:US
Practice Address - Phone:352-625-3737
Practice Address - Fax:352-625-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory