Provider Demographics
NPI:1376880542
Name:LEBRUN, ANGELA ELENA (ARNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ELENA
Last Name:LEBRUN
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21004 SW 92ND PL
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2457
Mailing Address - Country:US
Mailing Address - Phone:305-992-5629
Mailing Address - Fax:
Practice Address - Street 1:11255 SW 211TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-2240
Practice Address - Country:US
Practice Address - Phone:786-430-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9279913363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health