Provider Demographics
NPI:1659338556
Name:HADLEY, HOLLY WEAVER (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:WEAVER
Last Name:HADLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13901 US HIGHWAY 1 STE 5
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1612
Mailing Address - Country:US
Mailing Address - Phone:561-630-0840
Mailing Address - Fax:561-630-0336
Practice Address - Street 1:13901 US HIGHWAY 1
Practice Address - Street 2:SUITE 5
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1612
Practice Address - Country:US
Practice Address - Phone:561-630-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056616207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09634OtherBCBS
FL09634OtherBCBS
FL09634YMedicare ID - Type Unspecified