MEDICARE: DR. ANGEL A. DE ARMENDI

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	174400000X	Specialist	17369	PR
2	208D00000X	General Practice Physician	ACN460	FL

General Provider Information

NPI Number	:	1316190358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGEL A. DE ARMENDI

Provider Business Mailing Address
First Line	:	9725 NW 117TH AVE STE 200
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33178-1260
Country	:	US
Telephone Number	:	954-432-0578
Fax Number	:

Provider Business Practice Location Address
First Line	:	5190 NW 167TH ST STE 109
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-6329
Country	:	US
Telephone Number	:	855-226-6633
Fax Number	:	844-224-2818

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

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	02/04/2020

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