1972719946 NPI number — JOSEPH V DANGELO M D P A

Table of content: (NPI 1972719946)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972719946 NPI number — JOSEPH V DANGELO M D P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH V DANGELO M D P A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972719946
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 14096
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33408-0096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-346-1193
Provider Business Mailing Address Fax Number:
561-863-6999

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1411 N FLAGLER DR
Provider Second Line Business Practice Location Address:
SUITE 6800
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33401-3404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-832-0183
Provider Business Practice Location Address Fax Number:
561-863-6999
Provider Enumeration Date:
05/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
D'ANGELO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
V
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-832-0183

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 50670 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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