Healthcare Provider Details

I. General information

NPI: 1598884496
Provider Name (Legal Business Name): CHRISTOPHER PHILIP HOLLOWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 CORAL RIDGE DR SUITE 106
CORAL SPRINGS FL
33076-3378
US

IV. Provider business mailing address

5850 CORAL RIDGE DR SUITE 106
CORAL SPRINGS FL
33076-3378
US

V. Phone/Fax

Practice location:
  • Phone: 954-714-8200
  • Fax: 954-840-2626
Mailing address:
  • Phone: 954-714-8200
  • Fax: 954-840-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME112955
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberME112955
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberME112955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: