Provider Demographics
NPI:1750639209
Name:GRIFFITH, HOLLY KENDALL (PA)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:KENDALL
Last Name:GRIFFITH
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Gender:F
Credentials:PA
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Mailing Address - Street 1:4850 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7260
Mailing Address - Country:US
Mailing Address - Phone:954-484-7030
Mailing Address - Fax:954-484-1280
Practice Address - Street 1:4850 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 143
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7260
Practice Address - Country:US
Practice Address - Phone:954-676-9980
Practice Address - Fax:954-676-5288
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
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Provider Licenses
StateLicense IDTaxonomies
FLPA9106171363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant