Individual
ANTHONY VINCENT DEANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11501 SW 40TH ST, MIAMI, FL 33165-3313
(305) 642-5366
Mailing address
8600 NW 41ST ST, DORAL, FL 33166-6202
(305) 642-5366
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT18299
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT18299
FLORIDA DEPARTMENT OF HEALTH LICENSE
FL
Enumeration date
05/14/2015
Last updated
05/14/2015
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