Healthcare Provider Details

I. General information

NPI: 1285031948
Provider Name (Legal Business Name): BEATRICE AIME CELIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 INGRAHAM AVE
HAINES CITY FL
33844-4327
US

IV. Provider business mailing address

47 5TH ST NW
WINTER HAVEN FL
33881-4672
US

V. Phone/Fax

Practice location:
  • Phone: 863-291-5110
  • Fax: 863-291-5128
Mailing address:
  • Phone: 863-291-5110
  • Fax: 863-291-5128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME145023
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number18761
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: