Provider Demographics
NPI:1003327016
Name:JONES, HOLLY N (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 AMBER BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-3301
Mailing Address - Country:US
Mailing Address - Phone:863-651-7154
Mailing Address - Fax:
Practice Address - Street 1:1157 MIRANDA LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-0763
Practice Address - Country:US
Practice Address - Phone:407-483-4950
Practice Address - Fax:407-442-3490
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110620363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant