Holthaus, Kevin

Holthaus, Kevin is an individual health care provider with primary practice located at 1361 13Th Ave S Ste 150, Jacksonville Beach FL 32250-3233. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Holthaus, Kevin can be contacted via phone (904) 242-7177.

Contact Information

Primary practice address
1361 13Th Ave S Ste 150 Jacksonville Beach FL 32250-3233
Phone: (904) 242-7177
Fax: (904) 242-7133
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME43785 Florida

Profile Details

NPI number 1003893215
LBN Legal business name Holthaus, Kevin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Nov 21st, 2007 - about 19 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 1003893215 NPPES
Florida Other 15832 BCBS
Florida Other 110241847 BCBS

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