Holloway, Sally Jo

Holloway, Sally Jo is an sole proprietor health care provider with primary practice located at 2070 Temple Ave , Merritt Island FL 32953-4221. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Adult Companion, Nursing Service Related Providers / Day Training/Habilitation Specialist. Nursing Service Related Providers / Adult Companion is her primary health care specialty. Holloway, Sally Jo can be contacted via phone (321) 453-8976.

Contact Information

Primary practice address
2070 Temple Ave Merritt Island FL 32953-4221
Phone: (321) 453-8976
Fax: (321) 453-8976
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Adult Companion 372600000X
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X

Profile Details

NPI number 1477536050
LBN Legal business name Holloway, Sally Jo
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 28th, 2005
Last updated Mar 30th, 2011 - about 13 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477536050 NPPES
Florida MEDICAID 676830098
Florida MEDICAID 676830096

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