| Seadipity Wellness Llc | |
|
22455 Flora Parke Xing Fernandina Beach FL 32034-8000 | |
| (904) 452-4790 | |
| (833) 907-2436 |
| Full Name | Seadipity Wellness Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 22455 Flora Parke Xing, Fernandina Beach, Florida |
| Authorized Official Name and Position | Angela O'donnell (APRN) |
| Authorized Official Contact | 9044524790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seadipity Wellness Llc 22455 Flora Parke Xing Fernandina Beach FL 32034-8000 Ph: (904) 452-4790 | Seadipity Wellness Llc 22455 Flora Parke Xing Fernandina Beach FL 32034-8000 Ph: (904) 452-4790 |
| NPI Number | 1336803642 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 07/18/2022 |
| Medicare PECOS PAC ID | 2860887189 |
|---|---|
| Medicare Enrollment ID | O20220322003171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336803642 | NPI | - | NPPES |
| Provider Name | Angela Windom O'donnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033540463 PECOS PAC ID: 3678701042 Enrollment ID: I20220322003214 |
| Provider Name | Sara Collette Masters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922882141 PECOS PAC ID: 8426590779 Enrollment ID: I20240603001499 |
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