Individual
DOMINICK JOSEPH ANGIOLILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP CARDIOLOGY DEPT., JACKSONVILLE, FL 32209
(904) 244-3660
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME99467
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME99467
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106635675A
—
GA
05
—
2777673-00
—
FL
Enumeration date
03/19/2007
Last updated
06/12/2018
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