DR. CELSO AGNER (NPI# 1194728964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194728964 |
| Entity Type | Individual |
| Full Name | DR. CELSO AGNER |
| Other Name | DR. CELSO AGNER |
| Credential | M.D., MSC |
| Practice Address |
1625 Se 3rd Avenue Suite 623 Fort Lauderdale FL 33316-2521 |
| Mailing Address |
1700 Nw 49th St Ste 125 Fort Lauderdale FL 33309-3763 |
| Practice Telephone | 9543203322 |
| Practice Fax Number | 9544627410 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2018-02-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036-116408 | IL | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
227395 | NY | Allopathic & Osteopathic Physicians |
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
ME 117153 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 010834000 | 05 | |
| NY | 02408684 | 05 | |
| IL | PTAN | 695540001 | 01 |
| FL | FLORIDA BLUE (BCBS) | 14U19 | 01 |
| Street Address |
1625 SE 3RD AVENUE SUITE 623 |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-2521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164884235 | North Broward Hospital District | Pediatrics | 1625 Se 3rd Avenue, Suite 635, Fort Lauderdale, FL 33316-2521 | 2016-03-28 |
| 1114366580 | North Broward Hospital District | Internal Medicine | 1625 Se 3rd Avenue, Suite 623, Fort Lauderdale, FL 33316-2521 | 2013-06-19 |
| 1962561647 | Michelle Grace Binns | Internal Medicine | 1625 Se 3rd Avenue, Suite 400, Fort Lauderdale, FL 33316-2521 | 2006-12-08 |
| 1922051614 | Matthew M Kenick | Physician Assistant | 1625 Se 3rd Avenue, Third Floor, Fort Lauderdale, FL 33316 | 2006-05-17 |
| 1376500645 | Pamela M Sutton | Family Medicine | 1625 Se 3rd Avenue, Suite 525, Fort Lauderdale, FL 33316 | 2006-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376745935 | Madhu B Vijayappa | Psychiatry & Neurology | 8984 Sw 64th Ln, Gainesville, FL 32608-8562 | 2007-06-04 |
| 1194837708 | Sally B Zachariah | Psychiatry & Neurology | 10000 Bay Pines Blvd,neurology Section, Vamedical Center,bay Pines, Bay Pines, FL 33744 | 2006-08-31 |
| 1740258110 | Nils H. Mueller-kronast | Psychiatry & Neurology | 8756 Boynton Beach Blvd Ste 2300, Boynton Beach, FL 33472-4439 | 2006-03-10 |
| 1063405975 | Mary June Derbenwick | Psychiatry & Neurology | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2005-08-25 |
| 1215475025 | Miami Stroke, LLC | Psychiatry & Neurology | 11750 Sw 40th St, Miami, FL 33175-3530 | 2017-02-01 |
| 1972918431 | David Stone | Psychiatry & Neurology | 1700 S Tamiami Trl, Sarasota, FL 34239-3509 | 2014-06-24 |
| 1972897023 | North Broward Hospital District | Psychiatry & Neurology | 201 E Sample Rd, Suite 106, Pompano Beach, FL 33064-3502 | 2011-06-07 |
| 1124337290 | Maxim Vladimirovich Mokin | Psychiatry & Neurology | 2 Tampa General Cir, 3rd Floor, Tampa, FL 33606-3603 | 2010-10-06 |
| 1144547134 | Muhammad Zeeshan Memon | Psychiatry & Neurology | 1611 Nw 12th Ave, Miami, FL 33136 | 2010-04-29 |
| 1497966394 | Ridwan Lin | Psychiatry & Neurology | 201 E Sample Rd, Pompano Beach, FL 33064-3502 | 2007-05-24 |
| Find all providers with the same taxonomy | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
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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.