Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Angela T Vandusen

Individual provider Pediatric Nurse Practitioner · NPI 1790653418

Angela T Vandusen is a Nurse Practitioner in Daytona Beach, Florida. Qualified in 2025, 1 year ago. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025

Practice location Address checks out

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone: (386) 425-5000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 11042915 (FL)

Record details

NPI number1790653418
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 24, 2025
Last updated in NPPESOctober 24, 2025
Certification dateOctober 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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