Provider Demographics
NPI:1033821954
Name:HOLISTIC HEALTH ORLANDO PLLC
Entity Type:Organization
Organization Name:HOLISTIC HEALTH ORLANDO PLLC
Other - Org Name:HOLISTIC MEDICINE WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-904-4623
Mailing Address - Street 1:1531 E IRLO BRONSON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-5821
Mailing Address - Country:US
Mailing Address - Phone:407-319-7541
Mailing Address - Fax:407-326-9478
Practice Address - Street 1:1531 E IRLO BRONSON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-5821
Practice Address - Country:US
Practice Address - Phone:407-319-7541
Practice Address - Fax:786-326-9478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-22
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty