Healthcare Provider Details

I. General information

NPI: 1124760939
Provider Name (Legal Business Name): SOL ANGEL COWART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 SACRAMENTO ST
DELTONA FL
32725-8420
US

IV. Provider business mailing address

1202 SACRAMENTO ST
DELTONA FL
32725-8420
US

V. Phone/Fax

Practice location:
  • Phone: 407-900-1288
  • Fax: 407-214-7845
Mailing address:
  • Phone: 407-900-1288
  • Fax: 407-214-7845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11019140
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF04220178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: