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General NPI Number Information
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NPI Number | 1740907146
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Entity Type | Organization
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Legal Business Name | CELESTA HEALTH LLC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 6685 FOREST HILL BLVD STE 205
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City | GREENACRES
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State | FL
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Zip | 33413-3357
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Country | US
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Telephone | 561-650-4699
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Fax |
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Provider Business Mailing Address
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Address Line | 5511 S CONGRESS AVE STE 125
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City | ATLANTIS
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State | FL
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Zip | 33462-1140
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Country | US
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Telephone | 561-650-4699
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | KEUNG LEE
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Credential | MD
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Telephone | 561-801-5835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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