Provider Demographics
NPI:1649499252
Name:CENTURY MEDICAL CENTER
Entity type:Organization
Organization Name:CENTURY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-962-1016
Mailing Address - Street 1:6517 TAFT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4048
Mailing Address - Country:US
Mailing Address - Phone:954-962-1016
Mailing Address - Fax:
Practice Address - Street 1:6517 TAFT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-4048
Practice Address - Country:US
Practice Address - Phone:954-962-1016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8316Medicare ID - Type UnspecifiedMEDICARE PART B
FL683207Medicare Oscar/Certification