Provider Demographics
NPI:1750771812
Name:PATEL, ANGELI (NURSE PRACTIONER)
Entity type:Individual
Prefix:
First Name:ANGELI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3723
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:21150 BISCAYNE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1231
Practice Address - Country:US
Practice Address - Phone:305-935-6000
Practice Address - Fax:305-935-6248
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9330962363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner