Provider Demographics
NPI:1093706145
Name:MAIO, ANGELA M (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:MAIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:100 SOUTH ASHLEY DRIVE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5318
Mailing Address - Country:US
Mailing Address - Phone:813-899-6220
Mailing Address - Fax:813-985-8006
Practice Address - Street 1:100 SOUTH ASHLEY DRIVE
Practice Address - Street 2:SUITE 1500
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5318
Practice Address - Country:US
Practice Address - Phone:813-899-6220
Practice Address - Fax:813-985-8006
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2020-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME1158162085B0100X, 2085R0202X
NY1916482085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008755400Medicaid
F85417Medicare UPIN
FLHJ198Medicare PIN