CELEBRITY MEDICAL CENTER LLC (NPI# 1437429073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437429073 |
| Entity Type | Organization |
| Organization Name | CELEBRITY MEDICAL CENTER LLC |
| Other Organization Name | CELEBRITY MEDICAL SPA, LLC |
| Practice Address |
36 S Main St Winter Garden FL 34787-3125 |
| Practice Telephone | 4073479886 |
| Practice Fax Number | 4073879887 |
| Mailing Telephone | 4073479886 |
| Mailing Fax Number | 4073879887 |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2015-12-22 |
| Authorized Official Name | DR. ELDAR BOLATOVICH BAIGABATOV (PRESIDENT) |
| Authorized Official Telephone | 4073479886 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FL BLUE | 007VR | 01 |
| Other Name | Type Code |
|---|---|
| Celebrity Medical Spa, LLC | Former Legal Business Name - Organization |
| Street Address |
36 S MAIN ST |
| City | WINTER GARDEN |
| State | FL |
| Zip Code | 34787-3125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104999655 | Eldar Bolatovich Baigabatov | Internal Medicine | 36 S Main St, Winter Garden, FL 34787-3125 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608736 | Mid-florida Endodontics - Winter Garden Pa | Dentist | 15815 Shaddock Drive, Unit-3, Winter Garden, FL 34787 | 2020-10-30 |
| 1770196131 | Hamlin Eye Care, LLC | Optometrist | 15820 Shaddock Drive, Suite 150, Winter Garden, FL 34787 | 2020-08-26 |
| 1710501879 | Hz Surgery Center LLC | Clinic/Center | 17085 Porter Road, Suite 110, Winter Garden, FL 34787 | 2020-06-04 |
| 1235759416 | Callie Rebecca Alt | Student in an Organized Health Care Education/Training Program | 2200 Fowler Grove Blvd, Suite 220, Winter Garden, FL 34787 | 2020-04-17 |
| 1992345102 | Advn Dental Partners Pa | Dentist | 516 S. Dillard Street, Winter Garden, FL 34787 | 2020-01-15 |
| 1942851225 | Sara Walker | Physical Therapist | 213 S Dillard Street, Suite 320c, Winter Garden, FL 34787 | 2019-09-26 |
| 1801449996 | Tiffani Green | Behavior Technician | 678 W Bay St Apt 52, Winter Garden, FL 34787 | 2019-07-18 |
| 1811461353 | Ricardo Villalobos Pa | Psychiatry & Neurology | 16606 Broadwater Ave, Winter Garden, FL 34787 | 2019-01-17 |
| 1871078089 | Alton Graydon Cumberbatch Sr. | Pharmacist | 646 S. Dillard Street, Winter Garden, FL 34787 | 2018-10-03 |
| 1629551395 | Andrew Petersen | Physical Therapy Assistant | 5204 W. Colonial Drive, Winter Garden, FL 34787 | 2018-09-10 |
| Find all providers in zip 34787 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861778896 | Florida Care Center Winter Garden, LLC | Clinic/Center | 319 S Dillard St, Winter Garden, FL 34787-3524 | 2011-10-21 |
| 1477103331 | Healy Chiropractic and Wellness Center LLC | Clinic/Center | 214 S Dillard St, Winter Garden, FL 34787-3523 | 2019-09-12 |
| 1851637664 | Community Health Center, Inc. | Clinic/Center | 1210 E Plant St, Suite 200, Winter Garden, FL 34787-2993 | 2012-12-26 |
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| Find all providers with the same taxonomy | ||||
| City | WINTER GARDEN |
| Zip Code | 34787 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.