MEDICARE: THE ANGELS CLINIC 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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1427038306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ANGELS CLINIC INC

Provider Business Mailing Address
First Line	:	2720 SW 137 AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175
Country	:	US
Telephone Number	:	305-551-6001
Fax Number	:	605-223-0446

Provider Business Practice Location Address
First Line	:	2720 SW 137 AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175
Country	:	US
Telephone Number	:	305-551-6001
Fax Number	:	605-223-0446

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROSA DANAUY
Credential	:
Telephone Number	:	305-551-6001

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	08/22/2020

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