Provider Demographics
NPI:1659899003
Name:BURROWES, CURTIS
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:BURROWES
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:PO BOX 17114
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33682-7114
Mailing Address - Country:US
Mailing Address - Phone:813-317-0143
Mailing Address - Fax:
Practice Address - Street 1:9300 N 16TH ST STE 201
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-8698
Practice Address - Country:US
Practice Address - Phone:813-317-0143
Practice Address - Fax:888-453-5103
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 253Z00000X, 261QD1600X
FL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022576700Medicaid