Provider Demographics
NPI:1295964377
Name:MANN, HOLLY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13712 NW 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9332
Mailing Address - Country:US
Mailing Address - Phone:352-672-1597
Mailing Address - Fax:
Practice Address - Street 1:13712 NW 26TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-9332
Practice Address - Country:US
Practice Address - Phone:352-672-1597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2024-08-13
Deactivation Date:2024-05-16
Deactivation Code:
Reactivation Date:2024-06-04
Provider Licenses
StateLicense IDTaxonomies
FLPS44955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist