Doctor Name: | LEANDRO XAVIER CENTENERA |
NPI Number: | 1194760678 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD2004-0079 |
Business Practice Address: | 5951 Jefferson St Ne Suite C Albuquerque, NM - 871093450 |
Business Phone Number: | 5058982468 |
Business Fax Number: | 5058981518 |
Mailing Address: | 5951 Jefferson St Ne, Suite C ALBUQUERQUE |
State: | NM |
Postal Code: | 871093450 |
Phone Number: | 5058982468 |
Fax Number: | 5058981518 |
NPI Enumeration Date: | 06/18/2006 |
NPI Last Update Date: | 11/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD2004-0079 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |