Provider Demographics
NPI:1437377041
Name:M & H HILLSBOROUGH CENTER
Entity Type:Organization
Organization Name:M & H HILLSBOROUGH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:DULCE
Authorized Official - Last Name:PENA DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-579-7807
Mailing Address - Street 1:720 E FLETCHER AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-2616
Mailing Address - Country:US
Mailing Address - Phone:813-579-7807
Mailing Address - Fax:813-979-8683
Practice Address - Street 1:720 E FLETCHER AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-2616
Practice Address - Country:US
Practice Address - Phone:813-579-7807
Practice Address - Fax:813-979-8683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty