Basic Information
| Provider Information | |||||||||
| NPI: | 1972719946 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOSEPH V DANGELO M D P A | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 14096 | ||||||||
| Address2: | |||||||||
| City: | NORTH PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334080096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613461193 | ||||||||
| FaxNumber: | 5618636999 | ||||||||
| Practice Location | |||||||||
| Address1: | 1411 N FLAGLER DR | ||||||||
| Address2: | SUITE 6800 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334013404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618320183 | ||||||||
| FaxNumber: | 5618636999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 02/28/2008 | ||||||||
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| AuthorizedOfficialLastName: | D'ANGELO | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5618320183 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 50670 | 01 | FL | BCBS | OTHER |