Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | ME 78250 | FL |
N | 208200000X | Surgeon | ME 78250 | FL |
N | 208600000X | Surgeon | ME 78250 | FL |
NPI | 1770577504 |
---|---|
Provider Name | Dr. Michael Angelis |
First Address | Orlando, FL 32804-5505 |
Second Address | Orlando, FL 32804-5505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 03/03/2016 |