Provider Demographics
NPI:1750125928
Name:CHERY, CANDICE RICARDA (CD-L, C-PPS, CD-PIC)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:RICARDA
Last Name:CHERY
Suffix:
Gender:F
Credentials:CD-L, C-PPS, CD-PIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 PARADE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3524
Mailing Address - Country:US
Mailing Address - Phone:813-389-9275
Mailing Address - Fax:
Practice Address - Street 1:5109 PARADE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-3524
Practice Address - Country:US
Practice Address - Phone:813-389-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula