Provider Demographics
NPI:1083811772
Name:CENTER FOR DIGESTIVE DISEASE & DISORDER AT CELEBRATION LLC
Entity Type:Organization
Organization Name:CENTER FOR DIGESTIVE DISEASE & DISORDER AT CELEBRATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-566-0700
Mailing Address - Street 1:PO BOX 22803
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32830-2803
Mailing Address - Country:US
Mailing Address - Phone:407-566-0700
Mailing Address - Fax:407-566-0712
Practice Address - Street 1:410 CELEBRATION PL STE 400
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5436
Practice Address - Country:US
Practice Address - Phone:407-566-0700
Practice Address - Fax:407-566-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071633207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty