MEDICARE: FABIOLA ANGLADE-PASCAL, PLLC

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	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1558191718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FABIOLA ANGLADE-PASCAL, PLLC

Provider Business Mailing Address
First Line	:	27520 PASTO DR
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33983-5874
Country	:	US
Telephone Number	:	941-628-0651
Fax Number	:

Provider Business Practice Location Address
First Line	:	514 E GRACE ST
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-6121
Country	:	US
Telephone Number	:	941-833-3850
Fax Number	:	941-833-3851

Authorized Official
Title or Position	:	FNP/PMHNP
Name	:	MRS. FABIOLA ANGLADE-PASCAL
Credential	:	APRN
Telephone Number	:	941-628-0651

Provider Enumeration Date	:	08/02/2024
Last Update Date	:	08/02/2024

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