# MDA ANGEL CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861351405
- **Authorized official:** MRS. LAKENDRA MONIQUE WILSON RN (OWNER)
- **Authorized official phone:** (727) 275-0459

## Contact information

- **Practice address:** 3661 PRESCOTT LOOP, LAKELAND, FL 33810-2863
- **Practice address phone:** (727) 400-2512
- **Mailing address:** 3661 PRESCOTT LOOP, LAKELAND, FL 33810-2863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 01/20/2026
- **Last updated:** 01/20/2026