Provider Demographics
NPI:1326075144
Name:HOLLAND, DAVID SJUR (PSYD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SJUR
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-3127
Mailing Address - Country:US
Mailing Address - Phone:561-338-9898
Mailing Address - Fax:561-392-2122
Practice Address - Street 1:1031 ROYAL PALM BLVD
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5341
Practice Address - Country:US
Practice Address - Phone:772-202-8822
Practice Address - Fax:772-205-2540
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6078103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3831Medicare ID - Type Unspecified