=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306456843
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA BARRINER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2020
-----------------------------------------------------
Last Update Date | 08/07/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 209 SAN CARLOS AVE STE 6
-----------------------------------------------------
City | SANFORD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32771-1412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-683-1373
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2331 RETREAT VIEW CIR
-----------------------------------------------------
City | SANFORD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32771-7297
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-683-1373
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 376J00000X
-----------------------------------------------------
Taxonomy Name | Homemaker
-----------------------------------------------------
License Number | 236876
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------