Individual
VANDELL DIONTA WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3722 CHIOS ISLAND RD, SEFFNER, FL 33584-8422
(813) 755-2045
Mailing address
8735 DUNWOODY PL STE N, ATLANTA, GA 30350-2995
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
05/10/2025
Last updated
05/10/2025
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