# SEADIPITY WELLNESS LLC

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

## Provider details

- **NPI number:** 1336803642
- **Authorized official:** ANGELA O'DONNELL APRN (APRN)
- **Authorized official phone:** (904) 452-4790

## Contact information

- **Practice address:** 22455 FLORA PARKE XING, FERNANDINA BEACH, FL 32034-8000
- **Practice address phone:** (904) 452-4790
- **Practice address fax:** (833) 907-2436
- **Mailing address:** 22455 FLORA PARKE XING, FERNANDINA BEACH, FL 32034-8000
- **Mailing address phone:** (904) 452-4790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/25/2021
- **Last updated:** 07/18/2022