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General NPI Number Information
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NPI Number | 1407666274
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Entity Type | Individual
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Provider Name | ANGELICA NICOLE MAZZOCCA RAUSEO
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Gender | Female
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 8900 N KENDALL DR
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 786-596-1960
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Fax |
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Provider Business Mailing Address
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Address Line | 4160 PINE RIDGE LN
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City | WESTON
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State | FL
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Zip | 33331-5030
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Country | US
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Telephone | 954-805-4349
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA1042
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License Number State | FL
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