Provider Demographics
NPI:1467277707
Name:PTAK, ANGELIKA MARIA (FNP)
Entity type:Individual
Prefix:
First Name:ANGELIKA
Middle Name:MARIA
Last Name:PTAK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 NW 93RD TER
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1439
Mailing Address - Country:US
Mailing Address - Phone:954-673-6558
Mailing Address - Fax:
Practice Address - Street 1:8201 NW 93RD TER
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1439
Practice Address - Country:US
Practice Address - Phone:954-673-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily