Provider Demographics
NPI:1902856594
Name:HEALTHCARE THERAPY CENTER
Entity Type:Organization
Organization Name:HEALTHCARE THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAGALY
Authorized Official - Middle Name:PAEZ
Authorized Official - Last Name:DICANIO
Authorized Official - Suffix:
Authorized Official - Credentials:AP LMT
Authorized Official - Phone:813-931-9311
Mailing Address - Street 1:1323 W BUSCH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7766
Mailing Address - Country:US
Mailing Address - Phone:813-931-9311
Mailing Address - Fax:813-249-1544
Practice Address - Street 1:1323 W BUSCH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7766
Practice Address - Country:US
Practice Address - Phone:813-931-9311
Practice Address - Fax:813-249-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 579171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty