Provider Demographics
NPI:1053452821
Name:CENTENO, ROBERT FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANCIS
Last Name:CENTENO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 24330
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00824-0330
Mailing Address - Country:US
Mailing Address - Phone:340-719-2777
Mailing Address - Fax:340-719-2772
Practice Address - Street 1:12 BEESTON HILL
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-719-2777
Practice Address - Fax:314-719-2772
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002001995208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1428OtherVIRGIN ISLANDS MEDICAL LICENSE
MOH63953Medicare UPIN
MO002013647Medicare ID - Type UnspecifiedMEDICARE NUMBER