Holt, John Blake

Holt, John Blake is an individual health care provider with primary practice located at 588 Sterthaus Dr , Ormond Beach FL 32174-5128. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Holt, John Blake can be contacted via phone (386) 672-9503.

Contact Information

Primary practice address
588 Sterthaus Dr Ormond Beach FL 32174-5128
Phone: (386) 672-9503
Fax: (386) 672-0386
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X ME58979 Florida
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME58979 Florida

Profile Details

NPI number 1932195385
LBN Legal business name Holt, John Blake
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Apr 19th, 2016 - about 8 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 1932195385 NPPES
Florida MEDICAID 012903200-GROUP
Florida Other 007WM
Florida Other DV0492-GROUP
Florida MEDICAID 371580900-INDIVIDUAL
Florida Other P01369815-INDIVIDUAL

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