Healthcare Provider Details

I. General information

NPI: 1467325522
Provider Name (Legal Business Name): HILLSBOROUGH THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2526 W TAMPA BAY BLVD STE E
TAMPA FL
33607-6803
US

IV. Provider business mailing address

2526 E TAMPA BAY BLVD SUITE E
TAMPA BAY FL
33607
US

V. Phone/Fax

Practice location:
  • Phone: 813-964-6825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JORGE LLANES
Title or Position: PRECIDENT
Credential:
Phone: 305-399-9418