Individual provider Active NPI

Angel David Beaton Villafruela, SA-C

  • Surgical Assistant
  • Tampa, FL
National Provider Identifier
1366388951
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
26-212 Issued in FL
Practice address
5012 N Hale Ave
Tampa, FL 33614-6547
Phone
(727) 560-0890
NPI assigned
Apr 27, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 26-212 FL Primary

Addresses

Primary practice location

5012 N Hale Ave
Tampa, FL 33614-6547

Mailing address

5012 N Hale Ave
Tampa, FL 33614-6547
Phone (727) 560-0890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26-212FLMDSurgical Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1366388951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 N HALE AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146547",
            "telephone_number": "727-560-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 N HALE AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146547",
            "telephone_number": "727-560-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATON VILLAFRUELA",
        "first_name": "ANGEL",
        "middle_name": "DAVID",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "26-212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.