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NPI Code Detail

MEDICARE: DR. ANGELA J KELEHER M.D.

MEDICARE: DR. ANGELA J KELEHER M.D.
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
1208600000XSurgery PhysicianMD070836LPA

General Provider Information

NPI Number : 1972510535
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA J KELEHER M.D.
Provider Business Mailing Address
First Line : PO BOX 1289
Second Line :
City : TAMPA
State : FL
Zip : 33601-1289
Country : US
Telephone Number : 813-844-8927
Fax Number :
Provider Business Practice Location Address
First Line : 10740 PALM RIVER RD STE 360
Second Line :
City : TAMPA
State : FL
Zip : 33619-4578
Country : US
Telephone Number : 813-844-7585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 02/02/2023

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