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General NPI Number Information
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NPI Number | 1750316048
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Entity Type | Organization
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Legal Business Name | ANGELA E. BORELAND
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1611 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-6262
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Fax | 305-585-2457
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Provider Business Mailing Address
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Address Line | 19320 NW 3RD CT
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3241
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Country | US
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Telephone | 954-432-4953
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Fax | 305-585-2457
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Authorized Official
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Title or Position | NURSE MANAGER
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Name | MRS. ANGELA EVETTE BORELAND
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Credential | RN
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Telephone | 305-585-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 1615812
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License Number State | FL
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