Active NPI
Candice Guevara, DO
- Pediatrics Physician
- St Petersburg, FL
National Provider Identifier
1780067389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OS15630
- Practice address
- 501 6TH Ave S
St Petersburg, FL 33701 - Phone
- (727) 767-3053
- Fax
- (727) 767-4889
- NPI assigned
- Jul 1, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | UO 4535 | FL | |
| Pediatrics Physician | 208000000X | OS15630 | FL | Primary |
Addresses
Primary practice location
501 6TH Ave S
St Petersburg, FL 33701
Mailing address
501 6TH Ave S
St Petersburg, FL 33701-4634
Phone (727) 767-3053
Other practice location 1
11100 Euclid Ave
Cleveland, OH 44106
Phone (216) 844-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS15630 | FL | MD | Pediatrics Physician |
| UO 4535 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Coast Neonatology, Inc. | Current | Accepting new patients | |
| All Children'S OB/GYN Specialists | Current | Accepting new patients | |
| Orlando Health, Inc. | Current | Accepting new patients |
Locations
5959 Central Ave
Ste 103
St Petersburg, FL 33710
Phone (727) 767-6060
501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060
Interoperability endpoints
- cguevara188798@orlandohealth.medalliesdirect.net
- cguevara734424@direct.hopkinsmedicine.org
Organizations & group practices 3
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.
-
- Neonatal-Perinatal Medicine Physician
- St Petersburg, FL
- NPI 1225085715
-
- Obstetrics & Gynecology Physician
- St Petersburg, FL
- NPI 1710213525
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1780067389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 6TH AVE S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014634",
"telephone_number": "727-767-3053",
"fax_number": "727-767-4889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 6TH AVE S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33701",
"telephone_number": "727-767-3053",
"fax_number": "727-767-4889"
}
],
"practiceLocations": [
{
"address_1": "11100 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "44106",
"country_code": "US",
"telephone_number": "216-844-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUEVARA",
"first_name": "CANDICE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-01",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "UO 4535",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "OS15630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.