Provider Demographics
NPI:1326720566
Name:CENTORI HEALTH, INC
Entity Type:Organization
Organization Name:CENTORI HEALTH, INC
Other - Org Name:CENTORI HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-778-7920
Mailing Address - Street 1:16 PELICAN DR
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1522
Mailing Address - Country:US
Mailing Address - Phone:754-778-7920
Mailing Address - Fax:
Practice Address - Street 1:333 LAS OLAS WAY # CU1
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2363
Practice Address - Country:US
Practice Address - Phone:754-778-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty