MEDICARE: ANGELS MEDICAL SERVICE INC.

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1255380333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS MEDICAL SERVICE INC.

Provider Business Mailing Address
First Line	:	7871 NW 169TH TER
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-3428
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6043 NW 167 STREET
Second Line	:	STE A-27
City	:	MIAMI LAKES
State	:	FL
Zip	:	33015
Country	:	US
Telephone Number	:	305-805-9606
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA BOADA
Credential	:
Telephone Number	:	305-817-3081

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/31/2014

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Directions to “ANGELS MEDICAL SERVICE INC. ” Practice Location

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