Edwin Brint Hollis

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA29942 Issued in FL

Practice address

113 Lielmanis Ave
Hurlburt Field, FL 32544-5613

Phone

(850) 881-4327

NPI assigned

Oct 21, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1417556424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613",
            "telephone_number": "850-881-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613",
            "telephone_number": "850-881-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "EDWIN",
        "middle_name": "BRINT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-21",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "PTA8654",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chuck Henderson, PA-C
• Cyanela Maria Hernandez Borrero, PSYD
• Bradley Craig Hoffman, PHARMD
• Richard D Hogan Jr., IDMT/NREMT-P
• Nathaniel Clay Hollandsworth, IDMT
• Crystal M Holmes, LCMHC
• Bradley Edward Hudson
• Hurlburt Call-in Refills Phcy
• Hurlburt Main Phcy
• Frederick Dale Hutchison, PA

• Physical Therapy Assistant in Hurlburt Field, FL
• Providers in Hurlburt Field, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.