Provider Demographics
NPI:1821525114
Name:HOLBROOK, VERONICA COLLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:COLLEEN
Last Name:HOLBROOK
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 1:113 RAVENSCROFT WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-9130
Mailing Address - Country:US
Mailing Address - Phone:858-699-6573
Mailing Address - Fax:
Practice Address - Street 1:4225 WOODBINE RD STE A
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-8791
Practice Address - Country:US
Practice Address - Phone:850-994-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0071865207Q00000X
FLME146137207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine