Provider Demographics
NPI:1477595148
Name:HOLFELDER, ROBERT P (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:P
Last Name:HOLFELDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-1981
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:7227 N HIGHWAY 1
Practice Address - Street 2:SUITE 100
Practice Address - City:PORT ST JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-5020
Practice Address - Country:US
Practice Address - Phone:321-637-1595
Practice Address - Fax:321-637-1596
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107588363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHW758YMedicare UPIN
PA091506Medicare ID - Type Unspecified