Provider Demographics
NPI:1194326371
Name:ANGEL, VANESSA (DPT)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:ANGEL
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:13564 VILLAGE PARK DR UNIT 125
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7761
Mailing Address - Country:US
Mailing Address - Phone:321-843-0287
Mailing Address - Fax:321-841-9823
Practice Address - Street 1:13564 VILLAGE PARK DR UNIT 125
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7761
Practice Address - Country:US
Practice Address - Phone:321-843-0287
Practice Address - Fax:321-841-9823
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT364812251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist