Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Devora Dionne Fedrick

Individual provider Physician Assistant · NPI 1699251959

Devora Dionne Fedrick is a Nurse Practitioner in Tampa, Florida. Qualified in 2018, 8 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
8
Licensed in
FL
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone: (813) 745-4673
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence APRN11017806 (FL)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence ARNP9411595 (FL)

Record details

NPI number1699251959
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 19, 2018
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026
Mailing addressPo Box 198441, Atlanta, GA 30384-8441

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc — 1135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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