Provider Demographics
NPI:1396496352
Name:LITTLE ANGEL'S EXPRESS INC.
Entity type:Organization
Organization Name:LITTLE ANGEL'S EXPRESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIKA
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:RICHMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DNP(C), MSN,ED,RN
Authorized Official - Phone:813-352-8824
Mailing Address - Street 1:426 BLAKELY CT
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-5357
Mailing Address - Country:US
Mailing Address - Phone:813-352-8824
Mailing Address - Fax:
Practice Address - Street 1:5226 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9335
Practice Address - Country:US
Practice Address - Phone:813-352-8824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory