Provider Demographics
NPI:1821345588
Name:PRESTON, ANGELIA (RRT)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:
Last Name:PRESTON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4297 CROOKED MILE RD
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-6304
Mailing Address - Country:US
Mailing Address - Phone:321-544-0583
Mailing Address - Fax:
Practice Address - Street 1:4297 CROOKED MILE RD
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-6304
Practice Address - Country:US
Practice Address - Phone:321-544-0583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-12
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT 3342227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered