Provider Demographics
NPI:1477538882
Name:HILLSBOROUGH COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:HILLSBOROUGH COUNTY HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:GIGLIO
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:813-307-8072
Mailing Address - Street 1:1105 E KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3511
Mailing Address - Country:US
Mailing Address - Phone:813-307-8072
Mailing Address - Fax:813-272-7240
Practice Address - Street 1:1105 E KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3511
Practice Address - Country:US
Practice Address - Phone:813-307-8072
Practice Address - Fax:813-272-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 10980251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1074121OtherNAPB NUMBER
FL055726907Medicaid
FLPH 10980OtherPHARMACY LICENSE #
FLPH 10980OtherPHARMACY LICENSE #
FLBH3184378OtherDEA