Individual
ANGELA GRAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9400 TURKEY LAKE RD, ORLANDO, FL 32819
(407) 351-8500
Mailing address
PO BOX 628296, ORLANDO, FL 32862-8296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAT9106794
FL
Other
Enumeration date
09/24/2012
Last updated
08/14/2018
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