Provider Demographics
NPI:1306887179
Name:NENINGER, CELESTINO C (MD)
Entity type:Individual
Prefix:
First Name:CELESTINO
Middle Name:C
Last Name:NENINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 BISCAYNE BLVD
Mailing Address - Street 2:APT 2104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1550
Mailing Address - Country:US
Mailing Address - Phone:813-391-1089
Mailing Address - Fax:
Practice Address - Street 1:7111 FAIRWAY DR STE 450
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-4200
Practice Address - Country:US
Practice Address - Phone:561-623-2015
Practice Address - Fax:561-623-2032
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82167208VP0014X
FLME 82167207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262117700Medicaid
FL262117700Medicaid
FL02274Medicare PIN