Provider Demographics
NPI:1174736110
Name:SOSA, ANGEL H (MA-42109)
Entity type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:H
Last Name:SOSA
Suffix:
Gender:M
Credentials:MA-42109
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3238
Mailing Address - Country:US
Mailing Address - Phone:786-970-7513
Mailing Address - Fax:
Practice Address - Street 1:559 E 17TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3238
Practice Address - Country:US
Practice Address - Phone:786-970-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA42109172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist