ANGELO CUSTODE HEALTHCARE NPI 1487056404

NPI Information

NPI: 1487056404
Provider Name: ANGELO CUSTODE HEALTHCARE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1804 OAKLEY SEAVER DR
SUITE F
CLERMONT, FL
ZIP 34711
Phone: (352) 404-7815
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ANGELO CUSTODE HEALTHCARE is a primary care clinic center in Clermont, FL. ANGELO CUSTODE HEALTHCARE NPI is 1487056404. The provider is registered as an organization entity type.

The provider's business location address is:

1804 OAKLEY SEAVER DR
SUITE F
CLERMONT, FL
ZIP 34711-925
Phone: (352) 404-7815
Fax: (352) 404-9603

The provider's authorized official is Milania Alessia Smith .
The authorized official title is Ptds and has the following contact phone number (352) 708-6591.

The enumeration date for this NPI number is 9/22/2014 and was last updated on 1/20/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	ME98015	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	277908100	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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