Provider Demographics
NPI:1013237825
Name:CELESTE, JORDAN GIPE ROGERS (MD)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:GIPE ROGERS
Last Name:CELESTE
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 1:500 WINDERLEY PL
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7247
Mailing Address - Country:US
Mailing Address - Phone:407-875-8784
Mailing Address - Fax:
Practice Address - Street 1:500 WINDERLEY PL
Practice Address - Street 2:STE 115
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7247
Practice Address - Country:US
Practice Address - Phone:407-875-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP01941207P00000X
FLME118489207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine