Provider Demographics
NPI:1487974168
Name:ANGELES, JANICE SILVA (DO)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:SILVA
Last Name:ANGELES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:SICAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:9159 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4910
Practice Address - Country:US
Practice Address - Phone:623-815-3380
Practice Address - Fax:623-815-3381
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034379208600000X
AZ006218208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6126643OtherCIGNA
AZ835058Medicaid
AZP01259090OtherRAILROAD MCR
AZ5293945OtherAETNA