Healthcare Provider Details

I. General information

NPI: 1235043415
Provider Name (Legal Business Name): FELIPE ANGEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2259 W HILLSBORO BLVD # A
DEERFIELD BCH FL
33442-1106
US

IV. Provider business mailing address

6252 N STATE ROAD 7 APT 308
COCONUT CREEK FL
33073-3686
US

V. Phone/Fax

Practice location:
  • Phone: 954-725-4160
  • Fax:
Mailing address:
  • Phone: 786-416-4969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number25539
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: