Healthcare Provider Details

I. General information

NPI: 1265364012
Provider Name (Legal Business Name): ANGELWINGS CARE NURSE REGISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5916 NW 56TH CIR
CORAL SPRINGS FL
33067-3526
US

IV. Provider business mailing address

5916 NW 56TH CIR
CORAL SPRINGS FL
33067-3526
US

V. Phone/Fax

Practice location:
  • Phone: 954-766-0610
  • Fax: 954-715-6116
Mailing address:
  • Phone: 954-766-0610
  • Fax: 954-715-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DELORES HEADLEY
Title or Position: OWNER
Credential:
Phone: 954-638-5056