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General NPI Number Information
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NPI Number | 1467277707
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Entity Type | Individual
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Provider Name | ANGELIKA MARIA PTAK FNP
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Gender | Female
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 8201 NW 93RD TER
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City | TAMARAC
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State | FL
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Zip | 33321-1439
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Country | US
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Telephone | 954-673-6558
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Fax |
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Provider Business Mailing Address
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Address Line | 8201 NW 93RD TER
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City | TAMARAC
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State | FL
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Zip | 33321-1439
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Country | US
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Telephone | 954-673-6558
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11036533
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License Number State | FL
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