Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN9839 | FL |
N | 1223G0001X | General Practice | DN9839 | FL |
N | 213EG0000X | General Practice | DN9839 | FL |
NPI | 1679669105 |
---|---|
Provider Name | Dr. Maria D. Demas |
First Address | Winter Park, FL 32789-6623 |
Second Address | Orlando, FL 32805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 13/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010519300 | (05) | FL |
072000300 | (05) | FL |