Individual
ANGELIQUE M STAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3978 W HILLSBOROUGH AVE UNIT 21B, TAMPA, FL 33614-5628
(813) 906-1412
(813) 413-1971
Mailing address
6100 BLUE LAGOON DR STE 365, MIAMI, FL 33126-7010
(786) 322-7333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
APRN9214698
FL
363LP0200X
Pediatric Nurse Practitioner
ARNP9214698
FL
Other
Enumeration date
10/05/2010
Last updated
03/10/2021
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