Basic Information
| Provider Information | |||||||||
| NPI: | 1750639209 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRIFFITH | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | KENDALL | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4850 W OAKLAND PARK BLVD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333137260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544847030 | ||||||||
| FaxNumber: | 9544841280 | ||||||||
| Practice Location | |||||||||
| Address1: | 4850 W OAKLAND PARK BLVD | ||||||||
| Address2: | SUITE 143 | ||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333137260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546769980 | ||||||||
| FaxNumber: | 9546765288 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2012 | ||||||||
| LastUpdateDate: | 08/15/2012 | ||||||||
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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 | 363A00000X | PA9106171 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.