1659537173 NPI number — DR. ANGELA M. FIORITA-DAY PSYD

Table of content: DR. ANGELA M. FIORITA-DAY PSYD (NPI 1659537173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659537173 NPI number — DR. ANGELA M. FIORITA-DAY PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIORITA-DAY
Provider First Name:
ANGELA
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FIORITA
Provider Other First Name:
ANGE
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSYD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659537173
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1468 BAYTOWNE AVE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIRAMAR BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32550-4523
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-567-4433
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4635 GULFSTARR DR STE 100D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DESTIN
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32541-0742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-898-0080
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/04/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  242556 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 10851 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)