MEDICARE: ANG LUXURY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1356295240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANG LUXURY

Provider Business Mailing Address
First Line	:	4674 TOWN CENTER PKWY APT 433
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-8917
Country	:	US
Telephone Number	:	904-515-8129
Fax Number	:

Provider Business Practice Location Address
First Line	:	4674 TOWN CENTER PKWY APT 433
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-8917
Country	:	US
Telephone Number	:	904-515-8129
Fax Number	:

Authorized Official
Title or Position	:	SOLE MBR
Name	:	ANGELA GAINES
Credential	:
Telephone Number	:	904-515-8129

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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Directions to “ANG LUXURY ” Practice Location

Language	Start Address	Practice Location

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