Provider Demographics
NPI:1710458575
Name:CELESTINE-COX, CECILLE (FNP)
Entity Type:Individual
Prefix:
First Name:CECILLE
Middle Name:
Last Name:CELESTINE-COX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3473 NW 181ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-3435
Mailing Address - Country:US
Mailing Address - Phone:305-904-8841
Mailing Address - Fax:305-474-0145
Practice Address - Street 1:13900 NE 3RD CT
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-2834
Practice Address - Country:US
Practice Address - Phone:305-893-2288
Practice Address - Fax:305-899-1391
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9497936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily