Individual
CANDICE L RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4048 EVANS AVE, SUITE 303, FORT MYERS, FL 33901-9322
(239) 332-5344
(239) 332-7246
Mailing address
4048 EVANS AVE, SUITE 303, FORT MYERS, FL 33901-9322
(239) 332-5344
(239) 332-7246
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN2023182
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
CHAMPUS
FL
05
—
033867200
—
FL
01
—
430004785
MEDICARE RR
FL
01
—
G1071
BCBS
FL
Enumeration date
10/26/2005
Last updated
06/10/2024
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