Healthcare Provider Details

I. General information

NPI: 1962306688
Provider Name (Legal Business Name): MILAN'S ANGEL COMPANION CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 KENDALL SPRINGS CT APT 102
BRANDON FL
33510-2491
US

IV. Provider business mailing address

2206 KENDALL SPRINGS CT APT 102
BRANDON FL
33510-2491
US

V. Phone/Fax

Practice location:
  • Phone: 813-731-7870
  • Fax:
Mailing address:
  • Phone: 813-731-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANIELLE SIMONE BULLOCK
Title or Position: OWNER
Credential:
Phone: 813-731-7870