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NPI Code Detail

MEDICARE: EMILY ANGELIS

MEDICARE:   EMILY  ANGELIS
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
1390200000XStudent in an Organized Health Care Education/Training ProgramFL

General Provider Information

NPI Number : 1558214197
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ANGELIS
Provider Business Mailing Address
First Line : 4036 BERMUDA GROVE PL
Second Line :
City : LONGWOOD
State : FL
Zip : 32779-3192
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 313 S LAKEWOOD DR
Second Line :
City : BRANDON
State : FL
Zip : 33511-2815
Country : US
Telephone Number : 813-842-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ EMILY ANGELIS ” Practice Location

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