Organization
SEADIPITY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA O'DONNELL APRN (APRN)
(904) 452-4790
Entity
Organization
Contact information
Practice address
22455 FLORA PARKE XING, FERNANDINA BEACH, FL 32034-8000
(904) 452-4790
(833) 907-2436
Mailing address
22455 FLORA PARKE XING, FERNANDINA BEACH, FL 32034-8000
(904) 452-4790
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
10/25/2021
Last updated
07/18/2022
Update your record
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