Healthcare Provider Details

I. General information

NPI: 1992904718
Provider Name (Legal Business Name): MOISE W ANGLADE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 JOHN F KENNEDY DR STE A
ATLANTIS FL
33462-6617
US

IV. Provider business mailing address

1447 MEDICAL PARK BLVD STE 101
WELLINGTON FL
33414-3164
US

V. Phone/Fax

Practice location:
  • Phone: 561-228-1995
  • Fax: 561-469-7965
Mailing address:
  • Phone: 561-753-0001
  • Fax: 561-753-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME108802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: