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General NPI Number Information
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NPI Number | 1174017495
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Entity Type | Organization
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Legal Business Name | WINGS OF AN ANGEL INC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 3600 S STATE ROAD 7 STE 21
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City | MIRAMAR
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State | FL
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Zip | 33023-5288
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Country | US
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Telephone | 754-888-9074
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Fax | 754-888-9110
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Provider Business Mailing Address
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Address Line | 7957 ORLEANS ST
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City | MIRAMAR
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State | FL
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Zip | 33023-3561
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Country | US
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Telephone | 786-985-0690
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Fax | 754-888-9175
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Authorized Official
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Title or Position | CEO
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Name | DENEZE M DOUGLAS
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Credential |
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Telephone | 786-985-0690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 24912
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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