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NPI Code Detail

MEDICARE: MS. ANGEL INFUSO

MEDICARE:  MS. ANGEL  INFUSO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianI512000965270FL

General Provider Information

NPI Number : 1205340544
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGEL INFUSO
Provider Business Mailing Address
First Line : 2225 NE RUSTIC PL
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-5517
Country : US
Telephone Number : 772-475-5598
Fax Number :
Provider Business Practice Location Address
First Line : 247 SW PORT ST LUCIE BLVD
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34984-5015
Country : US
Telephone Number : 772-207-1356
Fax Number : 772-742-2924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2017
Last Update Date : 11/22/2017

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Directions to “ MS. ANGEL INFUSO ” Practice Location

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