Provider Demographics
NPI:1255134169
Name:SOSA, ANGELA P
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:P
Last Name:SOSA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 AXEL GRAESON AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5281
Mailing Address - Country:US
Mailing Address - Phone:407-600-0563
Mailing Address - Fax:
Practice Address - Street 1:1411 N DEAN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5518
Practice Address - Country:US
Practice Address - Phone:407-895-0801
Practice Address - Fax:407-895-0803
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health