Provider Demographics
NPI:1851680359
Name:PERRY B HOELTZELL, MD PA
Entity Type:Organization
Organization Name:PERRY B HOELTZELL, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-782-5757
Mailing Address - Street 1:601 E SAMPLE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-4443
Mailing Address - Country:US
Mailing Address - Phone:954-782-5757
Mailing Address - Fax:954-782-4293
Practice Address - Street 1:601 E SAMPLE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-4443
Practice Address - Country:US
Practice Address - Phone:954-782-5757
Practice Address - Fax:954-782-4293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL57647207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE53004Medicare UPIN