Organization
LUIS MARIO ANGLES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS MARIO ANGLES (OWNER)
(941) 378-4317
Entity
Organization
Contact information
Practice address
5413 HAYDEN BLVD, SARASOTA, FL 34232-5735
(941) 378-4317
Mailing address
5413 HAYDEN BLVD, SARASOTA, FL 34232-5735
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905482
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141647200
—
FL
Enumeration date
05/21/2013
Last updated
05/21/2013
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