Provider Demographics
NPI:1902206634
Name:PANELY, CELESTE (MS RD)
Entity Type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:
Last Name:PANELY
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 SW WHISPERING SOUND DR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-7735
Mailing Address - Country:US
Mailing Address - Phone:619-992-3943
Mailing Address - Fax:619-566-4160
Practice Address - Street 1:3725 SW WHISPERING SOUND DR
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-7735
Practice Address - Country:US
Practice Address - Phone:619-992-3943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA876458133V00000X, 133VN1005X
FLND9209133V00000X, 133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal