Healthcare Provider Details

I. General information

NPI: 1386291045
Provider Name (Legal Business Name): CENTRUM MEDICAL HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 SW 12TH AVE STE 100
MIAMI FL
33130-2431
US

IV. Provider business mailing address

9250 NW 36TH ST STE 420
DORAL FL
33178-2775
US

V. Phone/Fax

Practice location:
  • Phone: 305-266-2929
  • Fax: 786-558-0242
Mailing address:
  • Phone: 305-266-2929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TOMAS OROZCO
Title or Position: CEO
Credential:
Phone: 305-266-2929