Individual provider Active NPI

Angela Vallejo, PA-C

  • Physician Assistant
  • Cape Coral, FL
National Provider Identifier
1841514619
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105360 Issued in FL
Practice address
126 Del Prado Blvd N Ste 104
Cape Coral, FL 33909-2713
Phone
(239) 573-1606
Fax
(239) 573-1044
NPI assigned
Mar 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9105360 FL Primary

Addresses

Primary practice location

126 Del Prado Blvd N Ste 104
Cape Coral, FL 33909-2713

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

1708 Cape Coral Pkwy W Ste 6
Cape Coral, FL 33914-6985
Phone (239) 540-1495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229001151 FL Practitioner - Physician Assistant 6103014519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

126 Del Prado Blvd N
Cape Coral, FL 33909-2713

12995 S Cleveland Ave
Suite 184
Fort Myers, FL 33907-7703
Phone (239) 939-2201

13691 Metro Pkwy
Fort Myers, FL 33912-4322

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

1528 Del Prado Blvd S
Cape Coral, FL 33990-3798
Phone (239) 458-3338

1708 Cape Coral Pkwy W
Cape Coral, FL 33914-6985
Phone (239) 540-1495

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2002 Del Prado Blvd S
Suite 100
Cape Coral, FL 33990-4557
Phone (239) 217-4470

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

3434 Hancock Bridge Pkwy
Suite 301
North Fort Myers, FL 33903-7099
Phone (877) 856-3774

3571 Del Prado Blvd N
Suite 2
Cape Coral, FL 33909-5287
Phone (239) 656-6300

4881 Palm Beach Blvd
Suite 100
Fort Myers, FL 33905-3217
Phone (239) 693-9191

8380 Riverwalk Park Blvd
Fort Myers, FL 33919-8758

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince May 8, 2012 Accepting new patients
Millennium Physician Group LLC CurrentSince May 8, 2012 Accepting new patients

Locations

126 Del Prado Blvd N
Ste 104
Cape Coral, FL 33909
Phone (239) 573-1606

1708 Cape Coral Pkwy W
Ste 6
Cape Coral, FL 33914
Phone (239) 540-1495

13691 Metro Pkwy
Ste 330
Fort Myers, FL 33912
Phone (239) 310-5307

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1841514619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 DEL PRADO BLVD N STE 104",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092713",
            "telephone_number": "239-573-1606",
            "fax_number": "239-573-1044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Cape Coral Pkwy W Ste 6",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339146985",
            "country_code": "US",
            "telephone_number": "239-540-1495",
            "fax_number": "239-549-1080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "ANGELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-22",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.