Provider Demographics
NPI:1679330013
Name:CANIZARES, ANGELICA SOLANGE (APRN, WHCNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:SOLANGE
Last Name:CANIZARES
Suffix:
Gender:F
Credentials:APRN, WHCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-3808
Mailing Address - Country:US
Mailing Address - Phone:786-253-5001
Mailing Address - Fax:
Practice Address - Street 1:436 W 69TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-3808
Practice Address - Country:US
Practice Address - Phone:786-253-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031355363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health