Provider Demographics
NPI:1326214909
Name:CELEBRATION URGENT CARE CENTER PLLC
Entity Type:Organization
Organization Name:CELEBRATION URGENT CARE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NINO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIIULLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-240-0129
Mailing Address - Street 1:6525 W CAMPUS OVAL
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8830
Mailing Address - Country:US
Mailing Address - Phone:407-240-0129
Mailing Address - Fax:407-240-3693
Practice Address - Street 1:1530 CELEBRATION BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5158
Practice Address - Country:US
Practice Address - Phone:407-240-0129
Practice Address - Fax:407-240-3693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center