Provider Demographics
NPI:1972684967
Name:MOORE, CELINA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:MARIA
Last Name:MOORE
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 1:9970 CENTRAL PARK BLVD N STE 203
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2236
Mailing Address - Country:US
Mailing Address - Phone:561-487-1616
Mailing Address - Fax:561-391-2810
Practice Address - Street 1:9970 CENTRAL PARK BLVD N STE 203
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2236
Practice Address - Country:US
Practice Address - Phone:561-487-1616
Practice Address - Fax:561-487-1619
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93535208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics