Provider Demographics
NPI:1235933953
Name:BURTON, ANGELINA M
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:M
Last Name:BURTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 PULLMAN CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-4733
Mailing Address - Country:US
Mailing Address - Phone:904-840-5037
Mailing Address - Fax:
Practice Address - Street 1:6820 SOUTHPOINT PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6276
Practice Address - Country:US
Practice Address - Phone:904-299-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician