Provider Demographics
NPI:1659537173
Name:FIORITA-DAY, ANGELA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:FIORITA-DAY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ANGE
Other - Middle Name:M
Other - Last Name:FIORITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1468 BAYTOWNE AVE E
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-4523
Mailing Address - Country:US
Mailing Address - Phone:310-567-4433
Mailing Address - Fax:
Practice Address - Street 1:4635 GULFSTARR DR STE 100D
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-0742
Practice Address - Country:US
Practice Address - Phone:850-898-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY242556103TC0700X
FL10851103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100468080Medicaid