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NPI Code Detail

MEDICARE: DR. MARIO ANGELES JR. MD

MEDICARE:  DR. MARIO  ANGELES JR. MD
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
1207Q00000XFamily Medicine PhysicianU6914TX

General Provider Information

NPI Number : 1659990513
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIO ANGELES JR. MD
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number : 407-533-6836
Fax Number : 407-770-0661
Provider Business Practice Location Address
First Line : 7142 SAN PEDRO AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78216-6254
Country : US
Telephone Number : 726-268-7468
Fax Number : 855-618-2367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 04/06/2026

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Directions to “ DR. MARIO ANGELES JR. MD” Practice Location

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