Provider Demographics
NPI:1487537270
Name:BUENAVENTURA, VANDELL
Entity type:Individual
Prefix:
First Name:VANDELL
Middle Name:
Last Name:BUENAVENTURA
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 1:9214 LAKE CHASE ISLAND WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1934
Mailing Address - Country:US
Mailing Address - Phone:917-714-9793
Mailing Address - Fax:
Practice Address - Street 1:9214 LAKE CHASE ISLAND WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1934
Practice Address - Country:US
Practice Address - Phone:917-714-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter