Active NPI
Angel Manuel Gaetan, OWNER
- Driver
- Coral Springs, FL
National Provider Identifier
1205710118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- G225637380000
- Practice address
- 10777 W Sample Rd Apt 208
Coral Springs, FL 33065-3768 - Phone
- (954) 793-0905
- NPI assigned
- Aug 4, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | G225637380000 | FL | Primary |
Addresses
Primary practice location
10777 W Sample Rd Apt 208
Coral Springs, FL 33065-3768
Mailing address
10777 W Sample Rd Apt 208
Coral Springs, FL 33065-3768
Phone (954) 793-0905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G225637380000 | FL | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1205710118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10777 W SAMPLE RD APT 208",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330653768",
"telephone_number": "954-793-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10777 W SAMPLE RD APT 208",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330653768",
"telephone_number": "954-793-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAETAN",
"first_name": "ANGEL",
"middle_name": "MANUEL",
"credential": "OWNER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-04",
"last_updated": "2025-08-04",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "FL",
"license": "G225637380000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.