Most Relevant Information
Provider Data
| NPI Number: | 1003286824 |
| Provider Name: | JEFFREY LUDAN VONGJESDA MS, ARNP, NP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 60962308 |
Most Important Dates
| Enumeration Date: | 10/06/2015 |
| Last Updated: | 05/16/2024 |
Provider Practice Location
4565 US HIGHWAY 17 STE 106
FLEMING ISLAND
FL
320034822
Practice Location Phone/Fax
| Phone: | 9042694559 |
| Fax: | 9042694597 |
Provider Mailing Location
425 W COLONIAL DR STE 303
ORLANDO
FL
328046863
Provider Mailing Phone/Fax
| Phone: | 9047453618 |
| Fax: | 9047224271 |