Organization
SEA ANGEL MED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA GUADALUPE (OWNER/OPERATOR)
(561) 420-2437
Entity
Organization
Contact information
Practice address
4575 LUCERNE LAKES BLVD W APT 106, LAKE WORTH, FL 33467-8818
(561) 420-2437
Mailing address
4575 LUCERNE LAKES BLVD W APT 106, LAKE WORTH, FL 33467-8818
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
10/01/2020
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