Holly Tanner, PT

Physical Therapist in Melbourne, FL. Individual provider (NPI-1).

NPI number1669997888

StatusActive

Last updated in NPPESMar 16, 2020

Details

NPI: 1669997888
Entity type: Individual (NPI-1)
Name: Holly Tanner
Credential: PT
Sex: Female
Sole proprietor: Yes
Enumeration date: Aug 9, 2017
Certification date: Mar 16, 2020
Last updated: Mar 16, 2020

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225100000X	Physical Therapist	PT14594	FL	Yes

Practice location

205 E Nasa Blvd Ste 100
Melbourne, FL 32901-1953

Phone 321-361-5628 · Fax 321-728-4135

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306

Phone 321-434-3350 · Fax 321-728-4135

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physical Therapist providers in Melbourne, FL

All 160 Physical Therapist providers in Melbourne · All 6,122 providers in Melbourne

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