Healthcare Provider Details

I. General information

NPI: 1396650081
Provider Name (Legal Business Name): ANGELS DESTINATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15350 SW 50TH AVENUE RD
OCALA FL
34473-5013
US

IV. Provider business mailing address

15350 SW 50TH AVENUE RD
OCALA FL
34473-5013
US

V. Phone/Fax

Practice location:
  • Phone: 321-402-6698
  • Fax:
Mailing address:
  • Phone: 321-402-6698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MS. SANDRA MOISE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 321-402-6698