Provider Demographics
NPI:1164406492
Name:D'ANGELO, JOSEPH VINCENT (M D)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:VINCENT
Last Name:D'ANGELO
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14690
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-0690
Mailing Address - Country:US
Mailing Address - Phone:561-346-1193
Mailing Address - Fax:561-863-6999
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 6800
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-832-0183
Practice Address - Fax:561-863-6999
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0017816208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD55782Medicare UPIN
FL50670YMedicare PIN