MEDICARE: MRS. ANGELA PAEZ PHYSICIAN ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	PA9113702	FL

General Provider Information

NPI Number	:	1225636251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA PAEZ PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	2204 SW 13TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-1324
Country	:	US
Telephone Number	:	305-316-4170
Fax Number	:

Provider Business Practice Location Address
First Line	:	5040 NW 7TH ST STE 750
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3490
Country	:	US
Telephone Number	:	305-301-7169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2020
Last Update Date	:	10/12/2020

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Directions to “ MRS. ANGELA PAEZ PHYSICIAN ASSISTANT” Practice Location

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