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General NPI Number Information
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NPI Number | 1689961864
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Entity Type | Individual
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Provider Name | ANGELA CANDELARIA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 52 BEACH RD STE 105
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City | FAIRFIELD
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State | CT
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Zip | 06824-6017
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Country | US
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Telephone | 203-334-5959
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Fax | 203-298-9035
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Provider Business Mailing Address
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Address Line | 3300 S FISKE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-4306
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Country | US
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Telephone | 321-434-9358
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Fax | 321-951-7408
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 054643
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME127307
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License Number State | FL
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