Healthcare Provider Details

I. General information

NPI: 1326616533
Provider Name (Legal Business Name): ANGELINA AVDELLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELINA DAKKAK MD

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W MILLER ST
ORLANDO FL
32806-2009
US

IV. Provider business mailing address

83 W MILLER ST
ORLANDO FL
32806-2031
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-9792
  • Fax:
Mailing address:
  • Phone: 321-841-5281
  • Fax: 321-843-2068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME174833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: