CENTRUM MEDICAL CENTERS OF MARGATE, LLC NPI 1003422312

Clinic/Center in Margate, FL

NPI 1003422312 Organization Clinic/Center CLIA Number 10D2207566 CLIA Certificate of Waiver

About CENTRUM MEDICAL CENTERS OF MARGATE, LLC

Centrum Medical Centers Of Margate, Llc is a provider established in Margate, Florida specializing in clinic/center. The NPI number of Centrum Medical Centers Of Margate, Llc is 1003422312 and was assigned on September 2020. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated April 2021. Centrum Medical Centers Of Margate, Llc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Graciela V Victorero (Coo)

The CLIA number of Centrum Medical Centers Of Margate, Llc is 10D2207566 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Centrum Medical Centers Of Margate, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003422312

Provider NameCENTRUM MEDICAL CENTERS OF MARGATE, LLC
Provider Location Address612 S STATE ROAD 7 MARGATE, FL 33068
Provider Mailing Address5730 SW 74TH ST STE 200 SOUTH MIAMI, FL 33143
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-22-2020
Last Update Date04-01-2021


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

CENTRUM MEDICAL CENTERS OF MARGATE, LLC
612 S STATE ROAD 7
MARGATE, FL
ZIP 33068
Phone: (305) 266-2929

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Mailing Address

CENTRUM MEDICAL CENTERS OF MARGATE, LLC
5730 SW 74TH ST STE 200
SOUTH MIAMI, FL
ZIP 33143
Phone: (305) 266-2929



Authorized Official

Authorized Official Name GRACIELA V VICTORERO
Authorized Official TitleCOO
Authorized Official Phone(305) 266-2929

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003422312 is:

CLIA Number10D2207566
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineNo

Taxonomy Description: a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104961184 GREGOIRE GARCON MD
Individual
Podiatrist (Foot & Ankle Surgery)612 S STATE ROAD 7
MARGATE, FL 33068
(954) 535-1919
1073744843ACUREHAB & MEDICAL CENTER INC
Organization
Podiatrist612 S STATE ROAD 7
MARGATE, FL 33068
(954) 535-1919
1215460407 DAPHNIE SATINE MSN, ARNP, FNP-C
Individual
Nurse Practitioner (Family)612 S STATE ROAD 7
MARGATE, FL 33068
(954) 983-9191
1154811834PRIMARY CARE PHYSICIANS OF HOLLYWOOD, PL
Organization
Family Medicine612 S STATE ROAD 7
MARGATE, FL 33068
(954) 983-9191
1114408135 MARIA EUGENIA MORAN
Individual
Nurse Practitioner (Family)612 S STATE ROAD 7
MARGATE, FL 33068
(305) 266-2929

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.