Provider Demographics
NPI:1881193548
Name:D'ANGELO, MICHELE (CPM, LM)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 KINGS CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5716
Mailing Address - Country:US
Mailing Address - Phone:352-870-7610
Mailing Address - Fax:
Practice Address - Street 1:607 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5449
Practice Address - Country:US
Practice Address - Phone:352-372-4784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL357176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife