Healthcare Provider Details

I. General information

NPI: 1750771812
Provider Name (Legal Business Name): ANGELI PATEL NURSE PRACTIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21150 BISCAYNE BLVD STE 102
AVENTURA FL
33180-1231
US

IV. Provider business mailing address

15280 NW 79TH CT STE 200
MIAMI LAKES FL
33016-5873
US

V. Phone/Fax

Practice location:
  • Phone: 305-935-6000
  • Fax: 305-935-6248
Mailing address:
  • Phone: 305-558-3723
  • Fax: 786-907-4485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9330962
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9330962
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: