Healthcare Provider Details

I. General information

NPI: 1245321777
Provider Name (Legal Business Name): ANGELA FIONA CAMPBELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA CAMPBELL M.D.

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

V. Phone/Fax

Practice location:
  • Phone: 407-975-0406
  • Fax:
Mailing address:
  • Phone: 407-975-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME158354
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: