Organization
CELEBRITY MEDICAL CENTER LLC
Active
Other names
Celebrity Medical Spa, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELDAR BOLATOVICH BAIGABATOV M.D. (PRESIDENT)
(407) 347-9886
Entity
Organization
Contact information
Practice address
36 S MAIN ST, WINTER GARDEN, FL 34787-3125
(407) 347-9886
(407) 387-9887
Mailing address
36 S MAIN ST, WINTER GARDEN, FL 34787-3125
(407) 347-9886
(407) 387-9887
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007VR
FL BLUE
FL
Enumeration date
01/12/2012
Last updated
12/22/2015
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