Provider Demographics
NPI:1497710909
Name:FOX, CANDACE (MD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8501 SW 124TH AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4633
Mailing Address - Country:US
Mailing Address - Phone:305-595-6488
Mailing Address - Fax:305-595-5352
Practice Address - Street 1:8501 SW 124TH AVE STE 211
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4633
Practice Address - Country:US
Practice Address - Phone:305-595-6488
Practice Address - Fax:305-595-3532
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME67590208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG77343Medicare UPIN