Centurion Diagnostic, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

10D2041925 Issued in FL

Legal business name

CENTURION DIAGNOSTIC, INC.

Practice address

1399 Shotgun Rd
Sunrise, FL 33326-1981

Phone

(954) 678-1262

NPI assigned

Mar 6, 2015

Organization subpart

No

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

Authorized official

Name

Ruben Valdes

Title

President

Phone

(954) 594-4091

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425600000000",
    "number": "1467845032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 SHOTGUN RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 SHOTGUN RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261981",
            "telephone_number": "954-678-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTURION DIAGNOSTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-06",
        "last_updated": "2015-03-06",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-594-4091"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D2041925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID NUMBER",
            "identifier": "10D2041925",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.