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General NPI Number Information
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NPI Number | 1063677805
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Entity Type | Organization
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Legal Business Name | ANGEL CARE NURSING REGISTRY INC.
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 7401 WILES RD STE 229
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2036
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Country | US
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Telephone | 954-509-3806
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Fax |
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Provider Business Mailing Address
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Address Line | 7401 WILES RD STE 229
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2036
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Country | US
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Telephone | 954-509-3806
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CORETTA TOMBLING
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Credential | NURSE
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Telephone | 954-479-6922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 30211356
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License Number State | FL
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