Provider Demographics
NPI:1831291392
Name:SCHWARTZTOL, HOLLY W (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:W
Last Name:SCHWARTZTOL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9485 SW 72ND ST
Mailing Address - Street 2:SUITE A-222
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3242
Mailing Address - Country:US
Mailing Address - Phone:305-279-0007
Mailing Address - Fax:305-279-7407
Practice Address - Street 1:9485 SW 72ND ST
Practice Address - Street 2:SUITE A-222
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3242
Practice Address - Country:US
Practice Address - Phone:305-279-0007
Practice Address - Fax:305-279-7407
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 0003251103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75387Medicare ID - Type Unspecified