Provider Demographics
NPI:1679217301
Name:T P H T INC
Entity Type:Organization
Organization Name:T P H T INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:PARDO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-625-0587
Mailing Address - Street 1:1500 SW 131ST WAY APT N404
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2474
Mailing Address - Country:US
Mailing Address - Phone:954-625-0587
Mailing Address - Fax:954-697-0886
Practice Address - Street 1:3157 N UNIVERSITY DR STE 103
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2258
Practice Address - Country:US
Practice Address - Phone:954-625-0587
Practice Address - Fax:954-697-0886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty