Healthcare Provider Details

I. General information

NPI: 1033032362
Provider Name (Legal Business Name): CENTURION OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11120 NW GAINESVILLE RD
OCALA FL
34482-1479
US

IV. Provider business mailing address

1760 SUMMIT LAKE DR STE 105
TALLAHASSEE FL
32317-7942
US

V. Phone/Fax

Practice location:
  • Phone: 850-583-4801
  • Fax:
Mailing address:
  • Phone: 850-583-4801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. RUTH FELTNER
Title or Position: ADMINISTRATOR
Credential:
Phone: 850-583-4801