Healthcare Provider Details

I. General information

NPI: 1710379706
Provider Name (Legal Business Name): ANGELA LOUALAN LOUQUE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA LOUALAN MORGAN FNP-C

II. Dates (important events)

Enumeration Date: 02/27/2015
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 NW 10TH PL
GAINESVILLE FL
32605-4213
US

IV. Provider business mailing address

11770 US HIGHWAY 1 STE 102E
PALM BEACH GARDENS FL
33408-3052
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-3111
  • Fax:
Mailing address:
  • Phone: 561-815-2427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9414513
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN134287
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: