Provider Demographics
NPI:1639420367
Name:VISITING ANGELS
Entity Type:Organization
Organization Name:VISITING ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MEDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZIF
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:386-446-7848
Mailing Address - Street 1:185 CYPRESS POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-8407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:185 CYPRESS POINT PKWY
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-8407
Practice Address - Country:US
Practice Address - Phone:386-446-7848
Practice Address - Fax:386-447-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNR30211148251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health