Provider Demographics
NPI:1205420262
Name:KREBS, ANGELA C (PA-C)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:C
Last Name:KREBS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 UNIVERSITY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2197
Mailing Address - Country:US
Mailing Address - Phone:407-246-1788
Mailing Address - Fax:
Practice Address - Street 1:11500 UNIVERSITY BLVD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-2197
Practice Address - Country:US
Practice Address - Phone:407-712-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant