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General NPI Number Information
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NPI Number | 1972195048
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Entity Type | Individual
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Provider Name | ANDREW CAUDLE
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Gender | Male
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Dates
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Enumeration Date | 02/09/2021
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 301 MEMORIAL MEDICAL PKWY
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5167
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Country | US
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Telephone | 386-231-1500
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Fax | 386-231-1598
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Provider Business Mailing Address
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Address Line | 770 W GRANADA BLVD STE 101
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5179
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Country | US
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Telephone | 386-231-4519
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Fax | 386-368-8927
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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 | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN11040092
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License Number State | FL
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