Healthcare Provider Details

I. General information

NPI: 1144726258
Provider Name (Legal Business Name): ANGELA LAI FONG BOEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-1005
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-7067
  • Fax:
Mailing address:
  • Phone: 786-594-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME156987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: