Provider Demographics
NPI:1427482876
Name:CENTRO MEDICAL CENTER
Entity type:Organization
Organization Name:CENTRO MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-223-2770
Mailing Address - Street 1:8260 W FLAGLER ST STE 1E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2069
Mailing Address - Country:US
Mailing Address - Phone:305-223-2770
Mailing Address - Fax:305-226-2750
Practice Address - Street 1:8260 W FLAGLER ST STE 1E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2069
Practice Address - Country:US
Practice Address - Phone:305-223-2770
Practice Address - Fax:305-226-2750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center