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General NPI Number Information
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NPI Number | 1386661205
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Entity Type | Organization
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Legal Business Name | ANGELIQUE F. VARELA,M.D.
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 77 W FOREST AVE 202
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1479
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Country | US
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Telephone | 928-214-3667
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Fax | 928-773-2502
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Provider Business Mailing Address
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Address Line | 77 W FOREST AVE 202
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1479
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Country | US
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Telephone | 928-214-3667
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Fax | 928-773-2502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGELIQUE F VARELA
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Credential | M.D.
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Telephone | 928-214-3667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 22546
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License Number State | AZ
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