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General NPI Number Information
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NPI Number | 1285595660
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Entity Type | Organization
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Legal Business Name | CELEBRATION ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE INC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 339 CYPRESS PKWY STE 220
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City | KISSIMMEE
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State | FL
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Zip | 34759-3315
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Country | US
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Telephone | 321-939-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 2954 MALLORY CIR STE 101
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City | CELEBRATION
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State | FL
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Zip | 34747-1822
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | TINA MCKENNA
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Credential |
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Telephone | 321-939-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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