1982821849 NPI number — MRS. ANGELIA COLLINS WRIGHT RD, CSP, LDN

Table of content: MRS. ANGELIA COLLINS WRIGHT RD, CSP, LDN (NPI 1982821849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982821849 NPI number — MRS. ANGELIA COLLINS WRIGHT RD, CSP, LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
ANGELIA
Provider Middle Name:
COLLINS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RD, CSP, LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WRIGHT
Provider Other First Name:
ANGEL
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RD, CSP, LDN
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1982821849
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
918 KINGSCOTE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAFETY HARBOR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34695-5611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-725-7743
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 6TH ST S
Provider Second Line Business Practice Location Address:
DEPT OF NUTRITIONAL SERVICES
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33701-4816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-898-7451
Provider Business Practice Location Address Fax Number:
727-892-4399
Provider Enumeration Date:
04/19/2007

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: 133V00000X , with the licence number:  ND 3236 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 133VN1004X , with the licence number: ND 3236 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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