Healthcare Provider Details

I. General information

NPI: 1053654103
Provider Name (Legal Business Name): ANGELA RIPA LAFACE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA ASHLEY RIPA

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR # G417
TAMPA FL
33606-3571
US

IV. Provider business mailing address

48 ADALIA AVE
TAMPA FL
33606-3302
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-7968
  • Fax:
Mailing address:
  • Phone: 813-927-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberTRN19339
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: