Candice Chantracy Tatum

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS30579 Issued in FL

Practice address

4873 Plantation Blvd
North Port, FL 34289

Phone

(941) 255-1987

NPI assigned

Dec 20, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Guardian Pharmacy of Southwest Florida LLC

  • Long Term Care Pharmacy
  • North Port, FL
  • NPI 1285024125
  NPD
• Guardian Pharmacy of Southwest Florida LLC

  • Long Term Care Pharmacy
  • Naples, FL
  • NPI 1154147015
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1235375338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1922",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338831922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4873 PLANTATION BLVD",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34289",
            "telephone_number": "941-255-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "CANDICE",
        "middle_name": "CHANTRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-20",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS30579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T & S Psychiatric Consultants LLC
• Samantha Tabone
• Taisha Tadeus
• Nancy Tapia
• Markeisa Tassy
• Elyse Taylor, RN
• Theresa Louise Monica Taylor, LSW
• Pieter H. Tepaske
• Teri J Michel
• Nicole Teter

• Pharmacist in North Port, FL
• Providers in North Port, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.