Healthcare Provider Details

I. General information

NPI: 1831801182
Provider Name (Legal Business Name): ANGELS ON EARTH PPEC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7608 ALOMA AVE BLDG B
WINTER PARK FL
32792-9117
US

IV. Provider business mailing address

12200 MENTA ST STE 105
ORLANDO FL
32837-7540
US

V. Phone/Fax

Practice location:
  • Phone: 407-757-2257
  • Fax: 407-845-1102
Mailing address:
  • Phone: 407-757-2257
  • Fax: 407-854-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number
License Number State

VIII. Authorized Official

Name: ALEIDA CABRERA
Title or Position: PRESIDENT
Credential:
Phone: 407-757-2257