Provider Demographics
NPI:1932542057
Name:CATO, TANGELIA R
Entity Type:Individual
Prefix:
First Name:TANGELIA
Middle Name:R
Last Name:CATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 WELLCRAFT DR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-5971
Mailing Address - Country:US
Mailing Address - Phone:678-458-0633
Mailing Address - Fax:561-292-0573
Practice Address - Street 1:5440 WELLCRAFT DR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-5971
Practice Address - Country:US
Practice Address - Phone:678-458-0633
Practice Address - Fax:561-292-0573
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171W00000XOther Service ProvidersContractor