Individual
ANGELA WEAVER ABOUTANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2222 S HARBOR CITY BLVD, SUITE 430, MELBOURNE, FL 32901-5594
(321) 541-1777
(321) 725-5504
Mailing address
2222 S HARBOR CITY BLVD, MELBOURNE, FL 32901-5594
(321) 541-1777
(321) 725-5504
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME75529
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110171606
RAIL ROAD MEDICARE
FL
05
—
373042500
—
FL
Enumeration date
03/15/2006
Last updated
09/18/2014
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