Healthcare Provider Details

I. General information

NPI: 1528055274
Provider Name (Legal Business Name): PUXIAO CEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2005
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 E ALTAMONTE DR
ALTAMONTE SPRINGS FL
32701-4801
US

IV. Provider business mailing address

689 E ALTAMONTE DR
ALTAMONTE SPRINGS FL
32701-4801
US

V. Phone/Fax

Practice location:
  • Phone: 407-894-4474
  • Fax: 407-894-7136
Mailing address:
  • Phone: 407-894-4474
  • Fax: 407-894-7136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberME82046
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberME82046
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME82046
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: