Provider Demographics
NPI:1790730679
Name:MORROBEL, ANGEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:D
Last Name:MORROBEL
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 1:129 E REDSTONE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-5350
Mailing Address - Country:US
Mailing Address - Phone:850-279-3247
Mailing Address - Fax:850-279-4615
Practice Address - Street 1:4566 E HIGHWAY 20 STE 102
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8839
Practice Address - Country:US
Practice Address - Phone:850-279-3247
Practice Address - Fax:850-279-4615
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70304207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG27737Medicare UPIN
FL28912Medicare ID - Type Unspecified
FL250081700Medicare ID - Type Unspecified