Provider Demographics
NPI:1972373769
Name:VERDO, VANESSA (IBCLC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:VERDO
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10562 N ATHENIA DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-3283
Mailing Address - Country:US
Mailing Address - Phone:352-501-8210
Mailing Address - Fax:
Practice Address - Street 1:10562 N ATHENIA DR
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-3283
Practice Address - Country:US
Practice Address - Phone:352-501-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-300744174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN