Provider Demographics
NPI:1417541293
Name:ANGULO, MICHAEL DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DANIEL
Last Name:ANGULO
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 1:7340 SW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3610
Mailing Address - Country:US
Mailing Address - Phone:305-216-1213
Mailing Address - Fax:
Practice Address - Street 1:770 AVE HOSTOS STE 306
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1552
Practice Address - Country:US
Practice Address - Phone:787-834-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR35190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine