Provider Demographics
NPI:1265008726
Name:ANGELS ON EARTH PPEC, INC.
Entity Type:Organization
Organization Name:ANGELS ON EARTH PPEC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-757-2257
Mailing Address - Street 1:12200 MENTA ST STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7540
Mailing Address - Country:US
Mailing Address - Phone:407-757-2257
Mailing Address - Fax:407-845-1102
Practice Address - Street 1:7405 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-2100
Practice Address - Country:US
Practice Address - Phone:407-757-2257
Practice Address - Fax:407-845-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care