Provider Demographics
NPI:1215132246
Name:CELIGOJ, MICHELEANNE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELEANNE
Middle Name:
Last Name:CELIGOJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 N E ST
Mailing Address - Street 2:STE 331
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6335
Mailing Address - Country:US
Mailing Address - Phone:850-484-6500
Mailing Address - Fax:850-444-1755
Practice Address - Street 1:1200 HENLEY LN
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:FL
Practice Address - Zip Code:32531-2702
Practice Address - Country:US
Practice Address - Phone:850-969-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107756174400000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist