Provider Demographics
NPI:1023633971
Name:NURSE ANGEL, INC.
Entity type:Organization
Organization Name:NURSE ANGEL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LAVONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-310-7212
Mailing Address - Street 1:2981 NW 164TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2981 NW 164TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33054-6433
Practice Address - Country:US
Practice Address - Phone:305-310-7212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health