Jessica Candelo

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

206 Park Place Blvd
Kissimmee, FL 34741-2344

Phone

(407) 846-0023

NPI assigned

Oct 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1932863701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 MOONSTONE BND",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347582543",
            "telephone_number": "407-319-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412344",
            "telephone_number": "407-846-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELO",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel R Cancel-Jimenez, MD
• Isis Cancel
• Roxana M Cancel, B.S
• Jennifer Candelaria
• Miriam Luz Candelaria, LMHC
• Roscy Marianny Canelo Rodriguez
• Benjamin James Canfield, CRNA
• Martha M Cangas
• Quinton Micheal Cannon
• Tranard Cannon

• Counselor in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.

Verify at the official NPI Registry.