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General NPI Number Information
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NPI Number | 1396823696
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Entity Type | Organization
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Legal Business Name | ANGEL INSTITUTE INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 956 SW 82ND AVE
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City | MIAMI
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State | FL
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Zip | 33144-4270
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Country | US
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Telephone | 305-262-0938
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Fax | 305-262-0939
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Provider Business Mailing Address
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Address Line | 956 SW 82ND AVE
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City | MIAMI
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State | FL
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Zip | 33144-4270
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Country | US
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Telephone | 305-262-0938
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Fax | 305-262-0939
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Authorized Official
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Title or Position | PRESIDENT
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Name | GLADIMIR AZCUY
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Credential |
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Telephone | 305-262-0938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | HCC7315
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License Number State | FL
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