Healthcare Provider Details

I. General information

NPI: 1679378723
Provider Name (Legal Business Name): ANGEL URGENT CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 NW 52ND ST
MIAMI FL
33166-4845
US

IV. Provider business mailing address

7000 NW 52ND ST
MIAMI FL
33166-4845
US

V. Phone/Fax

Practice location:
  • Phone: 305-418-0847
  • Fax:
Mailing address:
  • Phone: 305-418-0847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LISBELLE EMMA REVOREDO
Title or Position: DIRECTOR
Credential:
Phone: 305-418-0847