Provider Demographics
NPI:1770502908
Name:TAPIA-CENTOLA, BEATRIZ (MD)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:TAPIA-CENTOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BEATRIZ
Other - Middle Name:
Other - Last Name:CENTOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 CRANBERRY HL
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7394
Mailing Address - Country:US
Mailing Address - Phone:781-290-0057
Mailing Address - Fax:617-812-0477
Practice Address - Street 1:1 CRANBERRY HL
Practice Address - Street 2:SUITE 303
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7394
Practice Address - Country:US
Practice Address - Phone:781-290-0057
Practice Address - Fax:617-812-0477
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2005028569207ZD0900X, 207ZP0101X
MA234758207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001496501Medicare PIN