Provider Demographics
NPI:1326320524
Name:CELEBRATION PEDIATRICS PA
Entity Type:Organization
Organization Name:CELEBRATION PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCANTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-566-9700
Mailing Address - Street 1:1530 CELEBRATION BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5164
Mailing Address - Country:US
Mailing Address - Phone:407-566-9700
Mailing Address - Fax:877-534-5105
Practice Address - Street 1:1530 CELEBRATION BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5164
Practice Address - Country:US
Practice Address - Phone:407-566-9700
Practice Address - Fax:877-534-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty