Provider Demographics
NPI:1376532655
Name:CENTURION, JOSE J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:J
Last Name:CENTURION
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9526 NE 2ND AVE
Mailing Address - Street 2:#102
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2750
Mailing Address - Country:US
Mailing Address - Phone:305-751-0007
Mailing Address - Fax:305-754-4947
Practice Address - Street 1:9526 NE 2ND AVE
Practice Address - Street 2:#102
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2750
Practice Address - Country:US
Practice Address - Phone:305-751-0007
Practice Address - Fax:305-754-4947
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2012-08-28
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Provider Licenses
StateLicense IDTaxonomies
FLME43332207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056481800Medicaid
FL056481800Medicaid
FLD21169Medicare UPIN
FL056481800Medicaid