Active NPI
Ralph Holly
- Psychiatry Physician
- Miami, FL
National Provider Identifier
1740940253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME101322
- Practice address
- 515 NW 152ND St
Miami, FL 33169-6615 - Phone
- (786) 303-5005
- NPI assigned
- Dec 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME101322 | FL | Primary |
Addresses
Primary practice location
515 NW 152ND St
Miami, FL 33169-6615
Mailing address
515 NW 152ND St
Miami, FL 33169-6615
Phone (786) 303-5005
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 |
|---|---|---|---|
| ME101322 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1740940253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 NW 152ND ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331696615",
"telephone_number": "786-303-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 NW 152ND ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331696615",
"telephone_number": "786-303-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLY",
"first_name": "RALPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-23",
"last_updated": "2021-12-23",
"certification_date": "2021-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME101322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.