Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Centrum Medical Group of North Carolina PLLC

Organization General Practice Physician · NPI 1063154375

Centrum Medical Group of North Carolina PLLC provides General Practice Physician services in Charlotte, North Carolina. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10320 Mallard Creek Rd Ste 180
Charlotte, NC 28262-5204
Phone: (305) 266-2929
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1063154375
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Graciela Victorero — Coo · (305) 266-2929
NPI enumeratedApril 8, 2022
Last updated in NPPESApril 8, 2022
Certification dateApril 8, 2022
Mailing address9250 Nw 36th St Ste 420, Doral, FL 33178-2775

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