Healthcare Provider Details

I. General information

NPI: 1932947231
Provider Name (Legal Business Name): ANGELA BATEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 389
ORLANDO FL
32804-4623
US

IV. Provider business mailing address

706 BRIDGEWAY BLVD
ORLANDO FL
32828
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5214
  • Fax: 407-303-5215
Mailing address:
  • Phone: 407-761-6236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: