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NPI Code Detail

MEDICARE: CENTRUM MEDICAL CENTERS OF NMB, LLC

MEDICARE: CENTRUM MEDICAL CENTERS OF NMB, LLC
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1912625146
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRUM MEDICAL CENTERS OF NMB, LLC
Provider Business Mailing Address
First Line : 9250 NW 36TH ST STE 420
Second Line :
City : DORAL
State : FL
Zip : 33178-2775
Country : US
Telephone Number : 305-266-2929
Fax Number :
Provider Business Practice Location Address
First Line : 1400 NE MIAMI GARDENS DR STE 105
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33179-4843
Country : US
Telephone Number : 305-266-2929
Fax Number : 305-225-6633
Authorized Official
Title or Position : CFO
Name : ALEXIS AGREDA
Credential :
Telephone Number : 305-266-2929
Provider Enumeration Date : 08/15/2022
Last Update Date : 02/27/2024

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Directions to “CENTRUM MEDICAL CENTERS OF NMB, LLC ” Practice Location

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