Healthcare Provider Details

I. General information

NPI: 1124144688
Provider Name (Legal Business Name): ANGELA RENAE BALDY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 N ROOSEVELT BLVD
KEY WEST FL
33040-7299
US

IV. Provider business mailing address

1100A DEWEY RD
KEY WEST FL
33040-6708
US

V. Phone/Fax

Practice location:
  • Phone: 305-293-4233
  • Fax: 305-293-4234
Mailing address:
  • Phone: 850-819-8477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberARNP3034202
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN229335
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP3034202
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP3034202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: