# CELEBRATION ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CELEBRATION ORTHOPAEDIC & SPORTS MEDICINE INSTITUTE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710869243
- **Legal business name:** CELEBRATION ORTHOPAEDIC & SPORTS MEDICINE INSTITUTE
- **Authorized official:** ENEIDA CARRASQUILLO (OPERATIONS MANAGER)
- **Authorized official phone:** (321) 939-0222

## Contact information

- **Practice address:** 173 N CHARLES RICHARD BEALL BLVD STE 106, DEBARY, FL 32713-2211
- **Practice address phone:** (321) 939-0222
- **Mailing address:** 2954 MALLORY CIR STE 101, KISSIMMEE, FL 34747-1822
- **Mailing address phone:** (321) 939-0222
- **Mailing address fax:** (321) 939-0225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2025
- **Last updated:** 10/01/2025