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Individual

MS. ANGELA P LAUBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3003 W DR MARTIN LUTHER KING JR BLVD FL 2, TAMPA, FL 33607-6307
(813) 554-8135
(813) 605-6098
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 532-1355
(813) 635-2613

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109310
FL
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant
PA9109310
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017334600
FL
01
IN651W
PTAN
FL
01
Y01T7
BCBS FL
FL
Enumeration date
11/05/2015
Last updated
07/10/2019
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