Provider Demographics
NPI:1346279411
Name:TERUEL, CANDACE R (ARNP)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:R
Last Name:TERUEL
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 1:1060 S OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-6576
Mailing Address - Country:US
Mailing Address - Phone:561-644-7191
Mailing Address - Fax:
Practice Address - Street 1:1060 S OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-6576
Practice Address - Country:US
Practice Address - Phone:561-644-7191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2235112363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306508100Medicaid
FLY058AZMedicare ID - Type Unspecified