Candace Brooke Boone Deberry, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9233668 Issued in FL

Practice address

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Phone

(813) 554-8387

Fax

(813) 554-8937

NPI assigned

Oct 20, 2016

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• The Eye Physicians of Pinellas, PA

  dba Largo Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Largo, FL
  • NPI 1366710741
  NPD (past)

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1679024087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-554-8387",
            "fax_number": "813-554-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-554-8387",
            "fax_number": "813-554-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERRY",
        "first_name": "CANDACE",
        "middle_name": "BROOKE BOONE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9233668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Michelle Deaton, LCSW
• Darcie M Deaver, NP-C
• Abigail Debacker, MD, RD, CNSC
• Kristinia Debarge
• David Michael Debauche, PH.D.
• Kristianna Deblasio, FNP
• Ashley Deboeuf, M.D.
• Deborah a Trehy MD PA & Pamela a Padilla MD PA (Trehy & Padilla MD)
• Deborah Laskowski
• Cynthia Debose

• Family Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.