Healthcare Provider Details
I. General information
NPI: 1578110557
Provider Name (Legal Business Name): CENTRUM MEDICAL HOLDINGS, LLC DBA CENTRUM HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2019
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4218 E 4TH AVE
HIALEAH FL
33013-2306
US
IV. Provider business mailing address
9250 NW 36TH ST STE 420
DORAL FL
33178-2775
US
V. Phone/Fax
- Phone: 305-266-2929
- Fax:
- Phone: 305-266-2929
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TOMAS
OROZCO
Title or Position: CEO
Credential:
Phone: 305-266-2929