Provider Demographics
NPI:1205278264
Name:CENTURY HEALTH CENTER
Entity type:Organization
Organization Name:CENTURY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZIM
Authorized Official - Middle Name:BAKSH
Authorized Official - Last Name:HAMID
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-985-8373
Mailing Address - Street 1:7402 N 56TH ST BLDG 900
Mailing Address - Street 2:SUITE 907
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-7733
Mailing Address - Country:US
Mailing Address - Phone:813-985-8373
Mailing Address - Fax:813-985-8373
Practice Address - Street 1:7402 N 56TH ST BLDG 900
Practice Address - Street 2:SUITE 907
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-7733
Practice Address - Country:US
Practice Address - Phone:813-985-8373
Practice Address - Fax:813-985-8373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLREG # 10-314 (DOH)261QH0100X
FLACHA 10D2061636261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service