Healthcare Provider Details

I. General information

NPI: 1871715383
Provider Name (Legal Business Name): ANGELA KING DEMPSEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA QUARLES KING MD

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 11/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 GREENWOOD BLVD
LAKE MARY FL
32746-5404
US

IV. Provider business mailing address

1070 GREENWOOD BLVD
LAKE MARY FL
32746-5404
US

V. Phone/Fax

Practice location:
  • Phone: 407-333-5111
  • Fax: 407-333-2434
Mailing address:
  • Phone: 407-333-5111
  • Fax: 407-333-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME0079419
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: