Provider Demographics
NPI:1679841217
Name:HOLTZMAN-DAVIS, MELISSA SUZANNE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:SUZANNE
Last Name:HOLTZMAN-DAVIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:DANIA
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4612
Mailing Address - Country:US
Mailing Address - Phone:954-923-7490
Mailing Address - Fax:954-923-8095
Practice Address - Street 1:501 E SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:DANIA
Practice Address - State:FL
Practice Address - Zip Code:33004-4612
Practice Address - Country:US
Practice Address - Phone:954-923-7490
Practice Address - Fax:954-923-8095
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-11
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist