Individual
ANDY ANGULO ONTIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
537 NW LAKE WHITNEY PL STE 101, PORT SAINT LUCIE, FL 34986-1620
(772) 462-3800
Mailing address
5150 NW MILNER DR, PORT SAINT LUCIE, FL 34983-3392
(772) 462-3800
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH32189
FL
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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