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NPI Code Detail

MEDICARE: CELINA ESTRELLA

MEDICARE:   CELINA  ESTRELLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant3687SC

General Provider Information

NPI Number : 1255870580
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELINA ESTRELLA
Provider Business Mailing Address
First Line : 2050 CORPORATE CENTRE DR STE 100
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-7428
Country : US
Telephone Number : 843-443-9368
Fax Number :
Provider Business Practice Location Address
First Line : 2050 CORPORATE CENTRE DR STE 100
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-7428
Country : US
Telephone Number : 843-443-9368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2017
Last Update Date : 02/20/2017

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Directions to “ CELINA ESTRELLA ” Practice Location

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