Provider Demographics
NPI:1487745246
Name:DEBUS, PAMELA (ARNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:DEBUS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 HANCOCK BRIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:N FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7094
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2625
Practice Address - Street 1:3390 TAMIAMI TRL
Practice Address - Street 2:STE 105
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8157
Practice Address - Country:US
Practice Address - Phone:941-883-5050
Practice Address - Fax:941-883-5055
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1546032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3819YMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER