Polidoro, Angelique Renae

Polidoro, Angelique Renae is an individual health care provider with primary practice located at 19531 Cochran Blvd , Port Charlotte FL 33948-2081. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Polidoro, Angelique Renae can be contacted via phone (941) 255-3535.

Contact Information

Primary practice address
19531 Cochran Blvd Port Charlotte FL 33948-2081
Phone: (941) 255-3535
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2010-01605 North Carolina
Allopathic & Osteopathic Physicians / General Practice 208D00000X 2010-01605 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS17556 Florida

Profile Details

NPI number 1396945317
LBN Legal business name Polidoro, Angelique Renae
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2007
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396945317 NPPES
North Carolina Other 2010-01605 MEDICAL LICENSE
North Carolina MEDICAID 5916841 MEDICAL LICENSE
North Carolina Other D09076700 MEDICAL LICENSE

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