Provider Demographics
NPI:1790208502
Name:ROUNDTREE, TANGELIA ANDREA (RN)
Entity Type:Individual
Prefix:
First Name:TANGELIA
Middle Name:ANDREA
Last Name:ROUNDTREE
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 1:7900 NW 27TH AVE STE E-12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4909
Mailing Address - Country:US
Mailing Address - Phone:305-495-2373
Mailing Address - Fax:
Practice Address - Street 1:7900 NW 27TH AVE STE E-12
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4909
Practice Address - Country:US
Practice Address - Phone:786-318-2337
Practice Address - Fax:786-318-2337
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9393049163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1205194883Medicaid