Provider Demographics
NPI:1720165749
Name:PANGAN, EDITHA ANGELITA (MD)
Entity Type:Individual
Prefix:DR
First Name:EDITHA
Middle Name:ANGELITA
Last Name:PANGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1397 MEDICAL PARK BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3186
Mailing Address - Country:US
Mailing Address - Phone:561-798-4900
Mailing Address - Fax:561-798-0722
Practice Address - Street 1:1397 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3186
Practice Address - Country:US
Practice Address - Phone:561-798-4900
Practice Address - Fax:561-798-0722
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME-0070022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine