Provider Demographics
NPI:1740605393
Name:MARIA E. HOLCOMB, D.O., LLC
Entity Type:Organization
Organization Name:MARIA E. HOLCOMB, D.O., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:813-313-7535
Mailing Address - Street 1:6601 MEMORIAL HWY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4501
Mailing Address - Country:US
Mailing Address - Phone:813-313-7535
Mailing Address - Fax:813-243-2343
Practice Address - Street 1:6601 MEMORIAL HWY
Practice Address - Street 2:SUITE 320
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4501
Practice Address - Country:US
Practice Address - Phone:813-313-7535
Practice Address - Fax:813-243-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS49702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty