Healthcare Provider Details

I. General information

NPI: 1568307247
Provider Name (Legal Business Name): ANGELICA SYLVESTER ANTAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E WARWICK DR
ALMA MI
48801-1014
US

IV. Provider business mailing address

300 E WARWICK DR
ALMA MI
48801-1014
US

V. Phone/Fax

Practice location:
  • Phone: 989-629-8140
  • Fax: 989-629-8145
Mailing address:
  • Phone: 989-629-8140
  • Fax: 989-629-8145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351056217
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: