Basic Information
| Provider Information | |||||||||
| NPI: | 1275695769 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOLLIMON | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | A.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7800 SW 87TH AVE | ||||||||
| Address2: | SUITE C-340 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331733570 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055950109 | ||||||||
| FaxNumber: | 3055957092 | ||||||||
| Practice Location | |||||||||
| Address1: | 244 N CONGRESS AVE | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617344535 | ||||||||
| FaxNumber: | 5617347530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 06/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | ARNP9193483 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 305519100 | 05 | FL | MEDICAID | ARNP9193483 | 01 | FL | ARNP LICENSE | OTHER |