Active NPI
Georgina Hollenbach
- Primary Care Nurse Practitioner
- Altamonte Springs, FL
National Provider Identifier
1679115190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 11017308
- Practice address
- 119 Larkspur Dr
Altamonte Springs, FL 32701-5208 - Phone
- (321) 947-9691
- NPI assigned
- Oct 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 9315185 | FL | |
| Primary Care Nurse Practitioner | 363LP2300X | 11017308 | FL | Primary |
Addresses
Primary practice location
119 Larkspur Dr
Altamonte Springs, FL 32701-5208
Mailing address
119 Larkspur Dr
Altamonte Springs, FL 32701-5208
Phone (321) 947-9691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9315185 | FL | MD | Registered Nurse |
| 11017308 | FL | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1679115190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 LARKSPUR DR",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327015208",
"telephone_number": "321-947-9691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 LARKSPUR DR",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327015208",
"telephone_number": "321-947-9691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLENBACH",
"first_name": "GEORGINA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-16",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "9315185",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "FL",
"license": "11017308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.