Organization
CENTRUM MEDICAL HOLDING OF LAKE WORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIELA VANESSA VICTORERO (COO)
(305) 266-2929
Entity
Organization
Contact information
Practice address
4560 LANTANA RD, LAKE WORTH, FL 33463-6998
(305) 266-2929
Mailing address
9250 NW 36TH ST STE 420, DORAL, FL 33178-2775
(305) 266-2929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/07/2025
Last updated
01/14/2025
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