Provider Demographics
NPI:1790756955
Name:DAMASK, CECELIA CONSTANCE (DO)
Entity Type:Individual
Prefix:DR
First Name:CECELIA
Middle Name:CONSTANCE
Last Name:DAMASK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CECELIIA
Other - Middle Name:CONSTANCE
Other - Last Name:BAUKUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:
Practice Address - Street 1:11317 LAKE UNDERHILL RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4452
Practice Address - Country:US
Practice Address - Phone:407-955-4948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9704207YX0602X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129FPMedicaid
NC19TC2OtherBCBS
NC89129FPMedicaid
FLP00391413Medicare PIN
I24728Medicare UPIN
FLAB582ZMedicare PIN