MEDICARE: DR. MICHAEL ANGELIS 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	204F00000X	Transplant Surgery Physician	ME 78250	FL
2	208600000X	Surgery Physician	ME 78250	FL

General Provider Information

NPI Number	:	1770577504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANGELIS MD

Provider Business Mailing Address
First Line	:	2415 N ORANGE AVE
Second Line	:	SUITE 700
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-2474
Fax Number	:	407-303-0680

Provider Business Practice Location Address
First Line	:	2415 N ORANGE AVE
Second Line	:	SUITE 700
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-2474
Fax Number	:	407-303-0680

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	03/03/2016

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Directions to “ DR. MICHAEL ANGELIS MD” Practice Location

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