Healthcare Provider Details

I. General information

NPI: 1316680192
Provider Name (Legal Business Name): ELIZABETH CELESTIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 N FEDERAL HWY
LIGHTHOUSE POINT FL
33064-6885
US

IV. Provider business mailing address

3320 N FEDERAL HWY
LIGHTHOUSE POINT FL
33064-6885
US

V. Phone/Fax

Practice location:
  • Phone: 754-222-6642
  • Fax: 954-943-1014
Mailing address:
  • Phone: 786-718-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11018987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: