Provider Demographics
NPI:1467687095
Name:HILL, CARLOS
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6756 MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4504
Mailing Address - Country:US
Mailing Address - Phone:813-810-9636
Mailing Address - Fax:
Practice Address - Street 1:6756 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4504
Practice Address - Country:US
Practice Address - Phone:813-810-9636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist