MEDICARE: IAN DEBUS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1063343697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IAN DEBUS MD

Provider Business Mailing Address
First Line	:	708 DEL PRADO BLVD S
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 DEL PRADO BLVD S
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:	239-343-9888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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Directions to “ IAN DEBUS MD” Practice Location

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