Provider Demographics
NPI:1770594145
Name:VECELLIO, ANGELA (DC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:VECELLIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 S FLAGLER DR
Mailing Address - Street 2:SUITES 1 & 2
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6736
Mailing Address - Country:US
Mailing Address - Phone:561-969-3232
Mailing Address - Fax:
Practice Address - Street 1:1309 S FLAGLER DR
Practice Address - Street 2:SUITES 1 & 2
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6736
Practice Address - Country:US
Practice Address - Phone:561-969-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1031111N00000X
FLCH9000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64041OtherBCBS OON FL
FL64041OtherBCBS OON FL
MS350000291Medicare ID - Type Unspecified