Provider Demographics
NPI:1790015600
Name:DEBUSK, CARA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CARA
Middle Name:
Last Name:DEBUSK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 VANDERBILT BEACH RD STE 1103
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0613
Mailing Address - Country:US
Mailing Address - Phone:239-596-5560
Mailing Address - Fax:239-596-7260
Practice Address - Street 1:2500 VANDERBILT BEACH RD STE 1103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0613
Practice Address - Country:US
Practice Address - Phone:239-596-5560
Practice Address - Fax:239-596-7260
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA-9105321363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCT011YMedicare PIN