Provider Demographics
NPI:1508654997
Name:BUNDZ, ANGELLA SUE (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELLA
Middle Name:SUE
Last Name:BUNDZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E DIXIE AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5997
Mailing Address - Country:US
Mailing Address - Phone:352-787-1535
Mailing Address - Fax:
Practice Address - Street 1:601 E DIXIE AVE STE 401
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5997
Practice Address - Country:US
Practice Address - Phone:352-787-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3306532363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health