MEDICARE: DR. MICHAEL DANIEL ANGULO MD

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	207Q00000X	Family Medicine Physician	35190	PR

General Provider Information

NPI Number	:	1417541293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DANIEL ANGULO MD

Provider Business Mailing Address
First Line	:	7340 SW 35TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-3610
Country	:	US
Telephone Number	:	305-216-1213
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 AVE HOSTOS STE 306
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1552
Country	:	US
Telephone Number	:	787-834-6161
Fax Number	:

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

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	04/12/2022

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