Healthcare Provider Details

I. General information

NPI: 1740818749
Provider Name (Legal Business Name): CEILIDH PARTNERSHIP LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 03/05/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E PAR ST STE 2000
ORLANDO FL
32804-3943
US

IV. Provider business mailing address

120 E PAR ST STE 2000
ORLANDO FL
32804-3943
US

V. Phone/Fax

Practice location:
  • Phone: 407-843-5665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BROCK MAGRUDER JR.
Title or Position: CEO
Credential: MD
Phone: 407-843-5565