MEDICARE: HADLEY WENDELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician	1457163214	IN

General Provider Information

NPI Number	:	1457163214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HADLEY WENDELL

Provider Business Mailing Address
First Line	:	4831 FLORIDA CLUB CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1088
Country	:	US
Telephone Number	:	502-608-5339
Fax Number	:

Provider Business Practice Location Address
First Line	:	4831 FLORIDA CLUB CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1088
Country	:	US
Telephone Number	:	502-608-5339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2025
Last Update Date	:	12/10/2025

Similar Medicare Providers

1588665863 — WENJING ADAMS CRNA, APRN
Practice Location Address:

11250 OLD SAINT AUGUSTINE RD , UNIT 266
JACKSONVILLE, FL
32257-1088

Practice Phone: 813-382-0004
Practice Fax:

1891760088 — YVETTE M MCQUEEN M.D.
Practice Location Address:

11250 OLD SAINT AUGUSTINE RD , SUITE 15324
JACKSONVILLE, FL
32257-1088

Practice Phone: 904-382-6907
Practice Fax: 904-268-3259

1639486616 — DR. DESIREA HAMILTON PHARM.D.
Practice Location Address:

11250 OLD SAINT AUGUSTINE RD , SUITE 4
JACKSONVILLE, FL
32257-1088

Practice Phone: 904-262-4250
Practice Fax:

1831436914 — DR. CRISTINA VIDA PHARMD
Practice Location Address:

11250 OLD SAINT AUGUSTINE RD
JACKSONVILLE, FL
32257-1088

Practice Phone: 904-262-4250
Practice Fax: 904-262-4035

1689911570 — VINCENT DOLCE PHARM.D.
Practice Location Address:

11250 OLD SAINT AUGUSTINE RD
JACKSONVILLE, FL
32257-1088

Practice Phone: 904-262-4250
Practice Fax: 904-262-4035

1730713868 — LAUREN DELAPARTE PHD
Practice Location Address:

11250 OLD SAINT AUGUSTINE RD STE 15-150
JACKSONVILLE, FL
32257-1088

Practice Phone: 904-201-9565
Practice Fax:

Directions to “ HADLEY WENDELL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.