Provider Demographics
NPI:1639649544
Name:JARZABEK, HOLLI MARIE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:HOLLI
Middle Name:MARIE
Last Name:JARZABEK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:HOLLI
Other - Middle Name:MARIE
Other - Last Name:YUCHKOVSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:216 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-1229
Mailing Address - Country:US
Mailing Address - Phone:860-471-9677
Mailing Address - Fax:
Practice Address - Street 1:5757 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4135
Practice Address - Country:US
Practice Address - Phone:954-734-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9396034363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health