=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972719946
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSEPH V DANGELO M D P A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 02/28/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1411 N FLAGLER DR SUITE 6800
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33401-3404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-832-0183
-----------------------------------------------------
Fax | 561-863-6999
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 14096
-----------------------------------------------------
City | NORTH PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33408-0096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-346-1193
-----------------------------------------------------
Fax | 561-863-6999
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JOSEPH V D'ANGELO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 561-832-0183
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------