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General NPI Number Information
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NPI Number | 1205373123
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Entity Type | Organization
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Legal Business Name | HILLSBOROUGH THERAPY CENTER INC
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 6105 MEMORIAL HWY SUITE S
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City | TAMPA
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State | FL
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Zip | 33615-4597
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Country | US
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Telephone | 813-964-6825
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Fax | 813-964-6829
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Provider Business Mailing Address
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Address Line | 6105 MEMORIAL HWY SUITE S
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City | TAMPA
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State | FL
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Zip | 33615-4597
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Country | US
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Telephone | 813-964-6825
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Fax | 813-964-6829
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Authorized Official
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Title or Position | OWNER
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Name | JORGE LUIS LLANES
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Credential |
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Telephone | 813-964-6825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC10797
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License Number State | FL
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