Provider Demographics
NPI:1568639383
Name:DELOS ANGELES, ADALGISA RAQUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADALGISA
Middle Name:RAQUEL
Last Name:DELOS ANGELES
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 1:10638 NW 69TH ST
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2966
Mailing Address - Country:US
Mailing Address - Phone:347-403-6678
Mailing Address - Fax:
Practice Address - Street 1:9800 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33351-4325
Practice Address - Country:US
Practice Address - Phone:954-475-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME1157132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1568639383Medicaid
FL1568639383Medicare Oscar/Certification