Healthcare Provider Details

I. General information

NPI: 1891604427
Provider Name (Legal Business Name): HECTOR LUIS CELDRAN JR.
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10437 NW 82ND ST UNIT 8
DORAL FL
33178-4383
US

IV. Provider business mailing address

10437 NW 82ND ST UNIT 8
DORAL FL
33178-4383
US

V. Phone/Fax

Practice location:
  • Phone: 786-828-1757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA101325
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: