Provider Demographics
NPI:1447863154
Name:AMANTE, ANGEL PAULO GOPEZ (MD)
Entity type:Individual
Prefix:DR
First Name:ANGEL PAULO
Middle Name:GOPEZ
Last Name:AMANTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CHESTNUT ST UNIT 705W
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1427
Mailing Address - Country:US
Mailing Address - Phone:313-455-7944
Mailing Address - Fax:
Practice Address - Street 1:1015 WALNUT ST BLDG SUITE620
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5005
Practice Address - Country:US
Practice Address - Phone:215-955-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PALT000867208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery