Provider Demographics
NPI:1336415355
Name:ANGULO, ANGELA M
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:ANGULO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9010 SW 137TH AVE STE 242
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1409
Mailing Address - Country:US
Mailing Address - Phone:305-388-0004
Mailing Address - Fax:305-388-8009
Practice Address - Street 1:9010 SW 137TH AVE STE 242
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1409
Practice Address - Country:US
Practice Address - Phone:305-388-0004
Practice Address - Fax:305-388-8009
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist