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Organization

ANGEL LAKE, MD

Active
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Organization

ANGEL LAKE, MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANGEL LAKE MD (PHYSICIAN/OWNER)
(340) 332-3665
Entity
Organization

Contact information

Practice address
4007 ESTATE DIAMOND RUBY, CHRISTIANSTED, VI 00820-4435
(340) 332-3665
(210) 682-9509
Mailing address
PO BOX 1051, CHRISTIANSTED, VI 00821-1051
(340) 332-3665
(210) 682-9509

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
11/20/2024
Last updated
02/13/2025
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