Provider Demographics
NPI:1275389017
Name:CENTRIC HEALTH CARE LLC
Entity Type:Organization
Organization Name:CENTRIC HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:G
Authorized Official - Last Name:GUASCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-209-2069
Mailing Address - Street 1:3850 BIRD RD STE 602
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1507
Mailing Address - Country:US
Mailing Address - Phone:305-209-2069
Mailing Address - Fax:305-390-3857
Practice Address - Street 1:9101 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2081
Practice Address - Country:US
Practice Address - Phone:305-209-2069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service