MEDICARE: CENTRUM MEDICAL HOLDINGS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1003422312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRUM MEDICAL HOLDINGS, LLC

Provider Business Mailing Address
First Line	:	9250 NW 36TH ST STE 420
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33178-2775
Country	:	US
Telephone Number	:	305-266-2929
Fax Number	:

Provider Business Practice Location Address
First Line	:	612 S STATE ROAD 7
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33068-1734
Country	:	US
Telephone Number	:	305-266-2929
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TOMAS OROZCO
Credential	:
Telephone Number	:	305-266-2929

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	12/16/2025

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