Provider Demographics
NPI:1285315804
Name:ALGARIN, HOLLY ANN
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ANN
Last Name:ALGARIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 ROYAL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-7251
Mailing Address - Country:US
Mailing Address - Phone:917-841-7987
Mailing Address - Fax:
Practice Address - Street 1:2202 MANDARIN LOOP
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:FL
Practice Address - Zip Code:33838-4387
Practice Address - Country:US
Practice Address - Phone:833-869-2423
Practice Address - Fax:863-869-6727
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-296318106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119139300Medicaid
FLRBT-23-296318OtherBACB