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Organization
ANGEL OAK
Active
Organization
ANGEL OAK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE DE CIUTIIS (OWNER/ADMINISTRATOR)
(352) 584-7473
Entity
Organization
Contact information
Practice address
1591 LARKIN RD, SPRING HILL, FL 34608-6451
(352) 584-7473
(352) 556-2612
Mailing address
1591 LARKIN RD, SPRING HILL, FL 34608-6451
(352) 584-7473
(352) 556-2612
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NULL
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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