Provider Demographics
NPI:1720690704
Name:CELENA VINENT CARBONELL M.D., P.A.
Entity Type:Organization
Organization Name:CELENA VINENT CARBONELL M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:VINENT CARBONELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-324-5688
Mailing Address - Street 1:1001 N MACDILL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5152
Mailing Address - Country:US
Mailing Address - Phone:813-324-5688
Mailing Address - Fax:813-549-3229
Practice Address - Street 1:1001 N MACDILL AVE STE D
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5152
Practice Address - Country:US
Practice Address - Phone:813-324-5688
Practice Address - Fax:813-549-3229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care