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General NPI Number Information
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NPI Number | 1659254456
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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 | 07/29/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 6718 LAKE NONA BLVD STE 110
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City | ORLANDO
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State | FL
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Zip | 32827-7984
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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 | 321-939-0222
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Fax | 321-939-0225
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | ENEIDA CARRASQUILLO
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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