Provider Demographics
NPI:1528469806
Name:BUENO, DEBORAH C (ARNP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:C
Last Name:BUENO
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:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-223-2832
Mailing Address - Fax:772-223-5653
Practice Address - Street 1:6901 SIMMONS LOOP
Practice Address - Street 2:4TH FLOOR
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-9498
Practice Address - Country:US
Practice Address - Phone:813-302-8388
Practice Address - Fax:813-302-8453
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9313233363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRZFALOtherFLORIDA BLUE
FL018350000Medicaid