Provider Demographics
NPI:1336372200
Name:HOLLANDER, AUDREY MAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:MAE
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:AUDREY
Other - Middle Name:MAE
Other - Last Name:HOLLANDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1954 DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:W MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-4045
Mailing Address - Country:US
Mailing Address - Phone:321-349-0456
Mailing Address - Fax:321-837-3954
Practice Address - Street 1:5501 RIVA RIDGE DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6509
Practice Address - Country:US
Practice Address - Phone:813-406-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9334187163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse