Healthcare Provider Details

I. General information

NPI: 1972466522
Provider Name (Legal Business Name): CELELRA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 WEST AVE UNIT 5
MIAMI BEACH FL
33139-1440
US

IV. Provider business mailing address

1819 WEST AVE UNIT 5
MIAMI BEACH FL
33139-1440
US

V. Phone/Fax

Practice location:
  • Phone: 701-381-2732
  • Fax:
Mailing address:
  • Phone: 701-381-2732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA3000X
TaxonomyAugmentative Communication Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW RUSILKO
Title or Position: CO FOUNDER
Credential: DO
Phone: 702-381-2732