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General NPI Number Information
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NPI Number | 1669884748
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Entity Type | Organization
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Legal Business Name | ANGELA M. GODWIN, NURSE PRACTITIONER IN FAMILY HEALTH, PLLC.
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 1469 ASTOR AVE
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City | BRONX
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State | NY
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Zip | 10469-5846
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Country | US
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Telephone | 347-871-3774
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Fax |
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Provider Business Mailing Address
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Address Line | 12001 AVALON LAKE DR APT 326
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City | ORLANDO
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State | FL
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Zip | 32828-7379
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Country | US
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Telephone | 646-457-8127
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Fax | 347-824-2978
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MISS DEBRA RODRIGUEZ
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Credential |
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Telephone | 646-457-8127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F335139-1
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License Number State | NY
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