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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 last year

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 1154760411 NPPES
Florida MEDICAID 105884500

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