Individual
LYNN MONDELUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1866 5TH AVE, DELAND, FL 32724-1605
(770) 616-4663
Mailing address
1866 5TH AVE, DELAND, FL 32724-1605
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN089084
GA
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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