| Centia Health Llc | |
|
11225 N 28th Dr Ste D220b Phoenix AZ 85029-5697 | |
| (623) 518-1025 | |
| (623) 666-6655 |
| Full Name | Centia Health Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 11225 N 28th Dr Ste D220b, Phoenix, Arizona |
| Authorized Official Name and Position | Sosunmolu Opeyemi Shoyinka (FOUNDER, CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2368424328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centia Health Llc 11225 N 28th Dr Ste D220b Phoenix AZ 85029-5697 Ph: (623) 518-1025 | Centia Health Llc 11225 N 28th Dr Ste D220b Phoenix AZ 85029-5697 Ph: (623) 518-1025 |
| NPI Number | 1972121218 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 08/04/2021 |
| Certification Date | 08/04/2021 |
| Medicare PECOS PAC ID | 1254731607 |
|---|---|
| Medicare Enrollment ID | O20210607002839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972121218 | NPI | - | NPPES |
| 550 | Other | NONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Rosine Ndayikeze Oriabure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083268874 PECOS PAC ID: 3274863105 Enrollment ID: I20190919001318 |
| Provider Name | Ibukun Odutola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801404074 PECOS PAC ID: 3971929704 Enrollment ID: I20201203001816 |
| Provider Name | Bolatito O Okougbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063095503 PECOS PAC ID: 5496157364 Enrollment ID: I20210714003065 |
| Provider Name | Adebola Abe-fapohunda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083227177 PECOS PAC ID: 1759784812 Enrollment ID: I20210826001714 |
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