Individual
MR. JOHN DANIEL VANDEVELDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
1261 VISCAYA PKWY STE 101, CAPE CORAL, FL 33990-3252
(239) 573-7337
(239) 574-5883
Mailing address
12730 NEW BRITTANY BLVD STE 602, FORT MYERS, FL 33907-4690
(239) 275-5522
(239) 275-4464
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP 9455776
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020729900
—
FL
01
—
BMBUO
FLORIDA BLUE
FL
Enumeration date
11/08/2005
Last updated
08/25/2020
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