Provider Demographics
NPI:1871929562
Name:WALKER, ANGELA GIULIANA
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:GIULIANA
Last Name:WALKER
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 1:720 SANTA ANA AVE
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-7435
Mailing Address - Country:US
Mailing Address - Phone:386-453-1837
Mailing Address - Fax:386-673-6934
Practice Address - Street 1:720 SANTA ANA AVE
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-7435
Practice Address - Country:US
Practice Address - Phone:386-453-1837
Practice Address - Fax:386-673-6934
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10123310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility