Provider Demographics
NPI:1205373123
Name:HILLSBOROUGH THERAPY CENTER INC
Entity Type:Organization
Organization Name:HILLSBOROUGH THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:LLANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-964-6825
Mailing Address - Street 1:6105 MEMORIAL HWY
Mailing Address - Street 2:SUITE S
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4597
Mailing Address - Country:US
Mailing Address - Phone:813-964-6825
Mailing Address - Fax:813-964-6829
Practice Address - Street 1:6105 MEMORIAL HWY
Practice Address - Street 2:SUITE S
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4597
Practice Address - Country:US
Practice Address - Phone:813-964-6825
Practice Address - Fax:813-964-6829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10797261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center