Healthcare Provider Details

I. General information

NPI: 1760937981
Provider Name (Legal Business Name): MEDICAL AND REHAB OF HILLSBOROUGH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016
Certification Date: MEDICAL AND REHAB OF HILLSBOROUGH INC. 8313 W HILLSBOROUGH AVE TAMPA FL 33615 8313 W HILLSBOROUGH AVE TAMPA FL 33615
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8313 W HILLSBOROUGH AVE STE. 330
TAMPA FL
33615-3816
US

IV. Provider business mailing address

8313 W HILLSBOROUGH AVE STE. 330
TAMPA FL
33615-3816
US

V. Phone/Fax

Practice location:
  • Phone: 813-443-8221
  • Fax: 813-443-1869
Mailing address:
  • Phone: 813-443-8221
  • Fax: 813-443-1869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberHCC10384
License Number StateFL

VIII. Authorized Official

Name: PEDRO HERNANDEZ
Title or Position: OWNER
Credential:
Phone: 813-443-8221