Healthcare Provider Details

I. General information

NPI: 1023317500
Provider Name (Legal Business Name): LAVINIU ION ANGHEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 SW 172ND AVE STE 212
MIRAMAR FL
33029-5613
US

IV. Provider business mailing address

1951 SW 172ND AVE STE 212
MIRAMAR FL
33029-5613
US

V. Phone/Fax

Practice location:
  • Phone: 954-507-4494
  • Fax: 954-507-4515
Mailing address:
  • Phone: 954-504-4494
  • Fax: 954-507-4515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NW0100X
TaxonomyWomen's Hospital
License Number4301097961
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME122662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: