Provider Demographics
NPI:1073557815
Name:ANGELLA, FARAHNAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:FARAHNAZ
Middle Name:
Last Name:ANGELLA
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 1:180 JFK DR
Mailing Address - Street 2:SUITE 311
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6641
Mailing Address - Country:US
Mailing Address - Phone:561-434-0353
Mailing Address - Fax:561-357-0869
Practice Address - Street 1:180 JFK DR
Practice Address - Street 2:SUITE 311
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6641
Practice Address - Country:US
Practice Address - Phone:561-434-0353
Practice Address - Fax:561-357-0869
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69298207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262752300Medicaid
H42861Medicare UPIN
FLE5845YMedicare PIN
FLE5848ZMedicare ID - Type Unspecified