Provider Demographics
NPI:1972951309
Name:HRISTOV, HOLLIE (FNP)
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:
Last Name:HRISTOV
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 GLADES ROAD, OFFICE BUILDING 1 FIRST FLOOR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-0000
Mailing Address - Country:US
Mailing Address - Phone:561-297-0372
Mailing Address - Fax:
Practice Address - Street 1:777 GLADES RD
Practice Address - Street 2:OFFICE BUILDING 1 FIRST FLOOR
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-0000
Practice Address - Country:US
Practice Address - Phone:561-297-0372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340627-1363LF0000X
FLAPRN11014651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily