Provider Demographics
NPI:1467917658
Name:CAMBRONNE, WANDA FLOWERS
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:FLOWERS
Last Name:CAMBRONNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 GREAT EGRET DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-2038
Mailing Address - Country:US
Mailing Address - Phone:352-314-2393
Mailing Address - Fax:352-314-2393
Practice Address - Street 1:5712 GREAT EGRET DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-2038
Practice Address - Country:US
Practice Address - Phone:352-314-2393
Practice Address - Fax:352-314-2393
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant