Centrum Medical Group of North Carolina PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CENTRUM MEDICAL GROUP OF NORTH CAROLINA PLLC

Practice address

10320 Mallard Creek Rd Ste 180
Charlotte, NC 28262-5204

Phone

(305) 266-2929

NPI assigned

Apr 8, 2022

Last updated

Apr 8, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Graciela Victorero

Title

Coo

Phone

(305) 266-2929

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1063154375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 NW 36TH ST STE 420",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782775",
            "telephone_number": "305-266-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 MALLARD CREEK RD STE 180",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625204",
            "telephone_number": "305-266-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRUM MEDICAL GROUP OF NORTH CAROLINA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "VICTORERO",
        "authorized_official_first_name": "GRACIELA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "305-266-2929"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Carolina Medical Clinic, P.a.
• Central Carolina Medical Clinic, PA (Central Carolina Medical Clinic, PA - Paw Creek Center)
• Central Pediatrics & Internal Medicine, PA
• Centralina Council of Governments Area Agency on Aging
• Centro Medico Latino, PC
• Christina Marie Cerenzia, DO
• Ariel Marion Cerenzie, OD
• Stephanie Cernuto, PA-C
• Pedro Cervantes Fanning, M.D.
• Cerwin Clinic of Chiropractic and Sports Medicine, P.a.

• General Practice Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.