Provider Demographics
NPI:1689924193
Name:CARRINGTON, ANGELA TIJUANA (RN)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:TIJUANA
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31952 NORTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-1621
Mailing Address - Country:US
Mailing Address - Phone:813-458-2019
Mailing Address - Fax:
Practice Address - Street 1:31952 NORTHRIDGE DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-1621
Practice Address - Country:US
Practice Address - Phone:813-458-2019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9626371320700000X
320700000X, 320900000X, 320700000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities