Provider Demographics
NPI:1447336292
Name:HANCOCK, ANGELA LOUISE (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LOUISE
Last Name:HANCOCK
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 1:1723 LUCERNE TER
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2916
Mailing Address - Country:US
Mailing Address - Phone:407-738-4200
Mailing Address - Fax:407-738-4200
Practice Address - Street 1:1723 LUCERNE TER
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2916
Practice Address - Country:US
Practice Address - Phone:407-738-4200
Practice Address - Fax:407-705-2540
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3179092363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003832600Medicaid
FLARNP3179092OtherMEDICAL LICENSE
FLFG209ZMedicare PIN