Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 11011739 | FL |
NPI | 1205420155 |
---|---|
Provider Name | Angela Marie Fregeolle |
First Address | Miami, FL 33186-2909 |
Second Address | Miami, FL 33186-2909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 22/02/2021 |