Provider Demographics
NPI:1285994590
Name:ALDER, ANGELA THERESE (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:THERESE
Last Name:ALDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19541 SW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6279
Mailing Address - Country:US
Mailing Address - Phone:954-450-8323
Mailing Address - Fax:954-450-8323
Practice Address - Street 1:19541 SW 53RD ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-6279
Practice Address - Country:US
Practice Address - Phone:954-450-8323
Practice Address - Fax:954-450-8323
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2806442363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health