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General NPI Number Information
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NPI Number | 1023153418
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Entity Type | Individual
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Provider Name | CELESTE NADINE WELCH PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 305 MEMORIAL MEDICAL PKWY STE 300
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5170
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Country | US
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Telephone | 386-231-3513
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Fax | 386-231-3612
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Provider Business Mailing Address
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Address Line | 770 W GRANADA BLVD STE 101
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5179
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Country | US
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Telephone | 386-405-2145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9104887
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License Number State | FL
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