Provider Demographics
NPI:1679369151
Name:PINE HILLS HEALTHCARE CENTER, INC
Entity type:Organization
Organization Name:PINE HILLS HEALTHCARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGMOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VIROJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-929-6903
Mailing Address - Street 1:9542 SHEPARD PL
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6420
Mailing Address - Country:US
Mailing Address - Phone:561-929-6903
Mailing Address - Fax:561-584-6222
Practice Address - Street 1:1013 N PINE HILLS RD UNIT 104
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7123
Practice Address - Country:US
Practice Address - Phone:561-929-6903
Practice Address - Fax:561-584-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service