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General NPI Number Information
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NPI Number | 1386462869
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Entity Type | Individual
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Provider Name | RILEY D'ANGELO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 8100 OAK LN STE 400
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5876
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Country | US
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Telephone | 305-888-0929
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Fax | 305-888-4044
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Provider Business Mailing Address
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Address Line | 3622 CORAL WAY APT 710
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City | MIAMI
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State | FL
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Zip | 33145-3286
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Country | US
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Telephone | 814-215-0938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9119279
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License Number State | FL
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