Provider Demographics
NPI:1578189692
Name:MORGAN, ANGELA BETH CUMMINGS (PT, DPT, GCS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:BETH CUMMINGS
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5958
Mailing Address - Country:US
Mailing Address - Phone:352-278-2897
Mailing Address - Fax:
Practice Address - Street 1:2202 BRYAN ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5958
Practice Address - Country:US
Practice Address - Phone:321-372-5102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist