Provider Demographics
NPI:1659084655
Name:HOLLOWAY, LAMERO DARNELL
Entity Type:Individual
Prefix:
First Name:LAMERO
Middle Name:DARNELL
Last Name:HOLLOWAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 MOUNTAIN SPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-7274
Mailing Address - Country:US
Mailing Address - Phone:727-946-5523
Mailing Address - Fax:
Practice Address - Street 1:12730 MOUNTAIN SPRINGS PL
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-7274
Practice Address - Country:US
Practice Address - Phone:727-946-5523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator