Provider Demographics
NPI:1831564772
Name:CELEBRATION CARDIOTHORACIC SURGERY ASSOCIATES PLLC
Entity type:Organization
Organization Name:CELEBRATION CARDIOTHORACIC SURGERY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARAGOZLOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-601-9600
Mailing Address - Street 1:19785 CRYSTAL ROCK DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4700
Mailing Address - Country:US
Mailing Address - Phone:301-601-9600
Mailing Address - Fax:301-601-3771
Practice Address - Street 1:400 CELEBRATION PL
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4970
Practice Address - Country:US
Practice Address - Phone:301-601-9600
Practice Address - Fax:301-601-3771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty