Active NPI
Holly Vandeman, MD
- Student in an Organized Health Care Education/Training Program
- Tampa, FL
National Provider Identifier
1790425320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 17 Davis Blvd Ste 308
Tampa, FL 33606-3438 - Phone
- (813) 974-2201
- NPI assigned
- Mar 31, 2022
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary | ||
| Obstetrics & Gynecology Physician | 207V00000X | DR.78506 | CO |
Addresses
Primary practice location
17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Mailing address
17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Other practice location 1
777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4949
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1790425320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 DAVIS BLVD STE 308",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 DAVIS BLVD STE 308",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063438",
"telephone_number": "813-974-2201"
}
],
"practiceLocations": [
{
"address_1": "777 Bannock St",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802044597",
"country_code": "US",
"telephone_number": "303-436-4949",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDEMAN",
"first_name": "HOLLY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-31",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CO",
"license": "DR.78506",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
- Brian Todd Vanaelst, D.M.D., M.S.
- Vanallen & Associates, Inc.
- Frederick A Vance, DDS
- Vancorp Holdings, Inc. (Cerna HomeCare of Tampa)
- Reese Vandeboe, RBT
- Laura Elizabeth Vandenberg, OD
- Kelly J Vander Bloomen, PT
- Lauren Vandergrift, LMT
- Elizabeth Anne Vanderlinden, COTA/L
- Rodney Dirk Vanderploeg, PH.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.