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Individual

NICHOLAS J ANGELASTRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1511 TAMIAMI TRL S, VENICE, FL 34285-5578
(941) 218-6839
(941) 218-6813
Mailing address
3604 TORREY PINES BLVD, SARASOTA, FL 34238-2827
(941) 218-6839
(941) 218-6813

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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