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

Mr. Blakely Austin Deboard

Individual provider Registered Nurse · NPI 1720623499

Mr. Blakely Austin Deboard is a Certified Registered Nurse Anesthetist (CRNA) in St Petersburg, Florida. Qualified in 2019, 7 years ago. Practices with Baycare Medical Group, Inc, a 1,530-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

6000 49th St N
St Petersburg, FL 33709-2114
Phone: (727) 521-4411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence APRN11005487 (FL)
Registered Nurse Taxonomy 163W00000X · Licence 9444134 (FL)

Record details

NPI number1720623499
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 16, 2019
Last updated in NPPESOctober 17, 2022
Certification dateOctober 17, 2022
Mailing address6918 Neopolitan Ct, Apollo Beach, FL 33572-1604

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Baycare Medical Group, Inc. — 1530 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in St Petersburg