Provider Demographics
NPI:1033107081
Name:ZAPPALA, ANGELO JOSEPH (DO)
Entity Type:Individual
Prefix:MR
First Name:ANGELO
Middle Name:JOSEPH
Last Name:ZAPPALA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 HEALTH CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-8127
Mailing Address - Country:US
Mailing Address - Phone:239-949-1050
Mailing Address - Fax:239-949-6111
Practice Address - Street 1:3501 HEALTH CENTER BLVD
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-8127
Practice Address - Country:US
Practice Address - Phone:239-949-1050
Practice Address - Fax:239-949-6111
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS61342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15838OtherBCBS
FLP00095814Medicare ID - Type UnspecifiedRAIL ROAD MCR
FLC32876Medicare UPIN
FL15838GMedicare ID - Type UnspecifiedMCR