Healthcare Provider Details

I. General information

NPI: 1750007324
Provider Name (Legal Business Name): MORGAN D'ANGELO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 W TOWN PL
ST AUGUSTINE FL
32092-3101
US

IV. Provider business mailing address

7385 PARK VILLAGE DR APT 2401
JACKSONVILLE FL
32256-8025
US

V. Phone/Fax

Practice location:
  • Phone: 904-342-5262
  • Fax:
Mailing address:
  • Phone: 267-272-1491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: