Provider Demographics
NPI:1306895537
Name:PINSON, ANGELA N (AUD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:N
Last Name:PINSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:N
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-1982
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:1223 GATEWAY DRIVE
Practice Address - Street 2:SUITE 1E
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2607
Practice Address - Country:US
Practice Address - Phone:321-725-4500
Practice Address - Fax:321-984-8483
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1268231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3636YMedicare PIN