Provider Demographics
NPI:1326099649
Name:MONHOLLON, JOHN PYLANT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PYLANT
Last Name:MONHOLLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2415 UNIVERSITY PKWY
Mailing Address - Street 2:SUITE 218
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2809
Mailing Address - Country:US
Mailing Address - Phone:941-955-6220
Mailing Address - Fax:941-955-1410
Practice Address - Street 1:2415 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 218
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2809
Practice Address - Country:US
Practice Address - Phone:941-955-6220
Practice Address - Fax:941-955-1410
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2015-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VAME 93678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA54-1439569OtherTAX PAYER ID#