Provider Demographics
NPI:1164088407
Name:MCDUFF, HOLLY
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:MCDUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1590 WOODBLUFF CT
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-9593
Mailing Address - Country:US
Mailing Address - Phone:803-743-7000
Mailing Address - Fax:
Practice Address - Street 1:1590 WOODBLUFF CT
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-9593
Practice Address - Country:US
Practice Address - Phone:850-476-0628
Practice Address - Fax:850-475-1313
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25347225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist