Provider Demographics
NPI:1003964198
Name:HOLODAR, CLARA I (ANP)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:I
Last Name:HOLODAR
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 CORPORATE LAKE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2367
Mailing Address - Country:US
Mailing Address - Phone:407-508-9545
Mailing Address - Fax:855-802-6942
Practice Address - Street 1:9009 CORPORATE LAKE DR
Practice Address - Street 2:STE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2367
Practice Address - Country:US
Practice Address - Phone:407-508-9545
Practice Address - Fax:855-802-6942
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY303034363LA2200X
FLARNP9356884363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health