Provider Demographics
NPI:1326928912
Name:HOLLEMAN, DOLORES SLAVIN (CME)
Entity type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:SLAVIN
Last Name:HOLLEMAN
Suffix:
Gender:F
Credentials:CME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 WARD LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-7476
Mailing Address - Country:US
Mailing Address - Phone:386-290-4017
Mailing Address - Fax:
Practice Address - Street 1:3508 S ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH SHORES
Practice Address - State:FL
Practice Address - Zip Code:32118-7639
Practice Address - Country:US
Practice Address - Phone:386-304-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLEO572247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other