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General NPI Number Information
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NPI Number | 1285805804
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Entity Type | Individual
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Provider Name | MRS. SYLVIA S. QUANDT
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Gender | Female
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Dates
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Enumeration Date | 03/23/2008
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Last Update Date | 03/23/2008
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Provider Practice Location Address
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Address Line | 1200 RED JOHN DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32124-1073
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Country | US
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Telephone | 386-947-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 16 SEA SWALLOW TER
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City | ORMOND BEACH
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State | FL
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Zip | 32176-2238
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Country | US
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Telephone | 386-441-9626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP9172519
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License Number State | FL
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