Provider Demographics
NPI:1801597638
Name:COLON, ANGELA G (CRT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:G
Last Name:COLON
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5699 BASSETT PL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-8501
Mailing Address - Country:US
Mailing Address - Phone:407-490-6448
Mailing Address - Fax:
Practice Address - Street 1:5699 BASSETT PL
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-8501
Practice Address - Country:US
Practice Address - Phone:407-490-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT12898227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified