Provider Demographics
NPI:1730725854
Name:POYEN, ANGELIQUE MICHELLE (DNP, APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:MICHELLE
Last Name:POYEN
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11750 CANAL ST UNIT 312
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7948
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1806 N FLAMINGO RD STE 150
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1029
Practice Address - Country:US
Practice Address - Phone:954-431-0131
Practice Address - Fax:954-431-3233
Is Sole Proprietor?:No
Enumeration Date:2019-11-24
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003951363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics