Provider Demographics
NPI:1871848671
Name:ANGULO DIAZ, VERONICA CAROLINA (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:CAROLINA
Last Name:ANGULO DIAZ
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 1:5709 GUNN HWY STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4104
Mailing Address - Country:US
Mailing Address - Phone:727-766-0000
Mailing Address - Fax:
Practice Address - Street 1:5709 GUNN HWY STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4104
Practice Address - Country:US
Practice Address - Phone:727-766-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT053584390200000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program