Provider Demographics
NPI:1639284193
Name:CELESTIN, SERGE (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGE
Middle Name:
Last Name:CELESTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6089
Mailing Address - Country:US
Mailing Address - Phone:954-227-2700
Mailing Address - Fax:954-227-2704
Practice Address - Street 1:1725 N UNIVERSITY DR
Practice Address - Street 2:SUITE 350
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6089
Practice Address - Country:US
Practice Address - Phone:954-227-2700
Practice Address - Fax:954-227-2704
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME656122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF43503Medicare UPIN