Provider Demographics
NPI:1982691754
Name:FALS, ANGELA M (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:FALS
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
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Mailing Address - Street 1:1801 LEE RD STE 307
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2101
Mailing Address - Country:US
Mailing Address - Phone:407-303-9200
Mailing Address - Fax:407-303-9201
Practice Address - Street 1:1801 LEE RD STE 307
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2101
Practice Address - Country:US
Practice Address - Phone:407-303-9200
Practice Address - Fax:407-303-9201
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME81834208000000X, 2080B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261753600Medicaid