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NPI Code Detail

MEDICARE: JASON ANDREW DEMERY PHD

MEDICARE: JASON ANDREW DEMERY PHD
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
1103G00000XClinical NeuropsychologistPY7500FL
2103TC0700XClinical PsychologistPY7500FL

General Provider Information

NPI Number : 1700077724
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON ANDREW DEMERY PHD
Provider Business Mailing Address
First Line : 8491 NW 39TH AVE
Second Line : UF SPRINGHILL HEALTH CENTER
City : GAINESVILLE
State : FL
Zip : 32606-5635
Country : US
Telephone Number : 352-265-3284
Fax Number : 352-265-3285
Provider Business Practice Location Address
First Line : 8491 NW 39TH AVE
Second Line : UF SPRINGHILL HEALTH CENTER
City : GAINESVILLE
State : FL
Zip : 32606-5635
Country : US
Telephone Number : 352-265-3284
Fax Number : 352-265-3285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2007
Last Update Date : 01/18/2011

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