NPIMap

Organization Active NPI

Medical & Rehab of Hillsborough Inc

  • Behavior Analyst
  • Tampa, FL
National Provider Identifier
1760937981
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
MEDICAL & REHAB OF HILLSBOROUGH INC
Practice address
2916 W Waters Ave
Tampa, FL 33614-1869
Phone
(813) 443-8221
Fax
(813) 443-1869
NPI assigned
Aug 17, 2016
Last updated
Mar 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pedro M Hernandez
Title
Owner
Phone
(813) 443-8221

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HCC10384 FL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

2916 W Waters Ave
Tampa, FL 33614-1869

Mailing address

PO Box 151686
Tampa, FL 33684-1686
Phone (813) 443-8221

Other identifiers 2

IdentifierTypeStateIssuer
HCC10384OtherFLAGENCY FOR HEALTH CARE ADMINISTRATION
109961000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220718001108 FL Part B Supplier - Clinic/Group Practice 6103207550 Receives reassigned benefits from 2 practitioners
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

2916 W Waters Ave
Tampa, FL 33614
Phone (813) 443-8221

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1760937981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151686",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336841686",
            "telephone_number": "813-443-8221",
            "fax_number": "813-443-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336141869",
            "telephone_number": "813-443-8221",
            "fax_number": "813-443-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL & REHAB OF HILLSBOROUGH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-443-8221"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC10384",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY FOR HEALTH CARE ADMINISTRATION",
            "identifier": "HCC10384",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109961000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.