Individual
MRS. ANGELA NICOLE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
120 S PALM AVE, PALATKA, FL 32177-4140
(386) 325-3500
Mailing address
105 DELLWOOD AVE, PALATKA, FL 32177-6508
(386) 312-8553
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2249
BLUECROSS AND BLUESHEILD
DC
Enumeration date
03/29/2007
Last updated
07/08/2007
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