Provider Demographics
NPI:1285805804
Name:QUANDT, SYLVIA S
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:S
Last Name:QUANDT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SYLVIA
Other - Middle Name:LEE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 SEA SWALLOW TER
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176-2238
Mailing Address - Country:US
Mailing Address - Phone:386-441-9626
Mailing Address - Fax:
Practice Address - Street 1:1200 RED JOHN DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-1073
Practice Address - Country:US
Practice Address - Phone:386-947-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-23
Last Update Date:2008-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9172519363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health