Provider Demographics
NPI:1861685919
Name:CELESTIN, CARMEL (MD)
Entity Type:Individual
Prefix:
First Name:CARMEL
Middle Name:
Last Name:CELESTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 CACTUS SUNRISE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6356
Mailing Address - Country:US
Mailing Address - Phone:216-855-1450
Mailing Address - Fax:
Practice Address - Street 1:851 S RAMPART BLVD STE 160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4885
Practice Address - Country:US
Practice Address - Phone:877-827-2362
Practice Address - Fax:877-827-2362
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107457246XC2903X
NV24272246XC2903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002431600Medicaid
OH2752801Medicaid
FL002431600Medicaid
OH7375291Medicare PIN