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General NPI Number Information
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NPI Number | 1679217301
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Entity Type | Organization
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Legal Business Name | T P H T INC
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 3157 N UNIVERSITY DR STE 103
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City | HOLLYWOOD
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State | FL
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Zip | 33024-2258
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Country | US
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Telephone | 954-625-0587
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Fax | 954-697-0886
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Provider Business Mailing Address
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Address Line | 1500 SW 131ST WAY APT N404
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-2474
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Country | US
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Telephone | 954-625-0587
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Fax | 954-697-0886
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS ALBERTO PARDO
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Credential | APRN
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Telephone | 954-625-0587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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