Healthcare Provider Details

I. General information

NPI: 1144252438
Provider Name (Legal Business Name): CELEBRATION OBSTETRICS AND GYNECOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PL SUITE 208
CELEBRATION FL
34747-5433
US

IV. Provider business mailing address

410 CELEBRATION PL SUITE 208
CELEBRATION FL
34747-5433
US

V. Phone/Fax

Practice location:
  • Phone: 407-566-2229
  • Fax: 407-566-2499
Mailing address:
  • Phone: 407-566-2229
  • Fax: 407-566-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID A MARCANTEL
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 877-800-0239