Provider Demographics
NPI:1932438769
Name:COLE, ANGELINA V (PA-C)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:V
Last Name:COLE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2905 N COMMERCE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3957
Mailing Address - Country:US
Mailing Address - Phone:954-967-6550
Mailing Address - Fax:954-967-8419
Practice Address - Street 1:3702 WASHINGTON ST
Practice Address - Street 2:SUITE 303
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8282
Practice Address - Country:US
Practice Address - Phone:954-967-6550
Practice Address - Fax:954-967-8419
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9105107363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant