Provider Demographics
NPI:1740246768
Name:HOLT, JULIE K (ARNPC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:K
Last Name:HOLT
Suffix:
Gender:F
Credentials:ARNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 CENTRE POINTE BLVD
Mailing Address - Street 2:SOUTHEASTERN UROLOGICAL CENTER PA
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-309-0400
Mailing Address - Fax:850-309-0404
Practice Address - Street 1:2000 CENTRE POINTE BLVD
Practice Address - Street 2:SOUTHEASTERN UROLOGICAL CENTER PA
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-309-0400
Practice Address - Fax:850-309-0404
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL596382208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P02126Medicare UPIN
000K0070Medicare ID - Type Unspecified