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Individual
NICHOLAS J ANGELASTRO
Active
Individual
NICHOLAS J ANGELASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS7504
FL
208D00000X
General Practice Physician
Primary
OS7504
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253150000
—
FL
01
—
57574
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/01/2005
Last updated
07/03/2020
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