Healthcare Provider Details

I. General information

NPI: 1972653665
Provider Name (Legal Business Name): ALBERTO E. ANGULO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E HILLSBORO BLVD SUITE 207
DEERFIELD BEACH FL
33441-4355
US

IV. Provider business mailing address

1500 E HILLSBORO BLVD SUITE 207
DEERFIELD BEACH FL
33441-4355
US

V. Phone/Fax

Practice location:
  • Phone: 954-428-2480
  • Fax: 954-428-2904
Mailing address:
  • Phone: 954-428-2480
  • Fax: 954-428-2904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME23285
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: