Healthcare Provider Details

I. General information

NPI: 1497085856
Provider Name (Legal Business Name): ANGELA C BRINSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NE 123RD ST STE 314
NORTH MIAMI FL
33181-2883
US

IV. Provider business mailing address

1801 NE 123RD ST STE 314
NORTH MIAMI FL
33181-2883
US

V. Phone/Fax

Practice location:
  • Phone: 954-257-7473
  • Fax: 877-478-5333
Mailing address:
  • Phone: 954-257-7473
  • Fax: 877-478-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberSS914
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS 914
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberSS914
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: