Provider Demographics
NPI:1174722920
Name:HILLSBOROUGH COUNTY DEPARTMENT OF AGING SERVICES
Entity type:Organization
Organization Name:HILLSBOROUGH COUNTY DEPARTMENT OF AGING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:QUALITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZONDO
Authorized Official - Suffix:
Authorized Official - Credentials:CPHQ
Authorized Official - Phone:813-272-5165
Mailing Address - Street 1:PO BOX 1110
Mailing Address - Street 2:AGING SERVICES, 25TH FLOOR
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1110
Mailing Address - Country:US
Mailing Address - Phone:813-272-5242
Mailing Address - Fax:813-272-6862
Practice Address - Street 1:601 E KENNEDY BLVD
Practice Address - Street 2:AGING SERVICES, 25TH FLOOR
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4156
Practice Address - Country:US
Practice Address - Phone:813-272-5242
Practice Address - Fax:813-272-6862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management