Provider Demographics
NPI:1962214718
Name:VENDRYES, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:VENDRYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9623 RAMPART RD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3339
Mailing Address - Country:US
Mailing Address - Phone:954-687-7131
Mailing Address - Fax:
Practice Address - Street 1:9623 RAMPART RD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3339
Practice Address - Country:US
Practice Address - Phone:954-687-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services