Holley, Tyler J
Holley, Tyler J is an individual health care provider with primary practice located at 207 W Gore St Ste 302 , Orlando FL 32806-1014. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Holley, Tyler J can be contacted via phone (407) 839-8407.Contact Information
Primary practice address
207 W Gore St Ste 302
Orlando FL 32806-1014
Phone: (407) 839-8407
Fax: (407) 839-8446
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 7135 | Nebraska |
Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN25920 | Florida |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 7135 | Nebraska |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | ME144719 | Florida |
Profile Details
NPI number | 1154760411 |
---|---|
LBN Legal business name | Holley, Tyler J |
Credentials | MD, DDS |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 20th, 2013 |
Last updated | Jan 8th, 2024 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1154760411 | NPPES |
Florida | MEDICAID | 105884500 |
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