Provider Demographics
NPI:1114969235
Name:D'ANGELO, MICHAEL F (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:D'ANGELO
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 1:10000 W COLONIAL DR STE 285
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3432
Mailing Address - Country:US
Mailing Address - Phone:407-298-6950
Mailing Address - Fax:407-578-2354
Practice Address - Street 1:10000 W COLONIAL DR STE 285
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3432
Practice Address - Country:US
Practice Address - Phone:407-298-6950
Practice Address - Fax:407-578-2354
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 84656208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10G240OtherHEALTHY KIDS
FL7602340OtherAETNA
FL15505OtherBCBS OF FL
FLP01214404OtherRAILROAD MCR
FLP109394OtherFREEDOM HEALTH
FL1192996OtherWELLCARE
FL024508700Medicaid
FL338577OtherAVMED
FL8894684OtherCIGNA
FLP109394OtherFREEDOM HEALTH
FL15505XMedicare PIN
FL1192996OtherWELLCARE
FL15505ZMedicare PIN