Centivo Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CENTIVO CARE

Practice address

174 W Comstock Ave Ste 100
Winter Park, FL 32789-4347

Phone

(716) 939-5564

NPI assigned

Mar 29, 2022

Last updated

Dec 1, 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

Ashlee Meghan Davidson

Title

Practice Manager

Phone

(716) 939-5564

Specialties & licenses 1

Addresses

Other names 1

• Centivo Virtual Primary Care Other name

Locations

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1629718804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 W COMSTOCK AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 W COMSTOCK AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894347",
            "telephone_number": "716-939-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTIVO CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_middle_name": "MEGHAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "716-939-5564"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centivo Virtual Primary Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Centivo Virtual Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Primary Care Clinic/Center in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.