MEDICARE: CENTURY ONE MEDICAL CENTER, CORP

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	261QM1300X	Multi-Specialty Clinic/Center	HCC6966	FL

General Provider Information

NPI Number	:	1538115811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTURY ONE MEDICAL CENTER, CORP

Provider Business Mailing Address
First Line	:	5545 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2274
Country	:	US
Telephone Number	:	305-441-5447
Fax Number	:

Provider Business Practice Location Address
First Line	:	5545 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2274
Country	:	US
Telephone Number	:	305-441-5447
Fax Number	:	305-441-5450

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROSALBA GARCIA
Credential	:
Telephone Number	:	305-441-5447

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	08/22/2020

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