Healthcare Provider Details
I. General information
NPI: 1851261929
Provider Name (Legal Business Name): CELSA MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6290 LINTON BLVD STE 203
DELRAY BEACH FL
33484-6409
US
IV. Provider business mailing address
6290 LINTON BLVD STE 203
DELRAY BEACH FL
33484-6409
US
V. Phone/Fax
- Phone: 305-380-2103
- Fax:
- Phone: 305-380-2103
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TAYLOR
BERGSTROM
Title or Position: PODIATRIST
Credential: DPM
Phone: 678-373-8114