Healthcare Provider Details

I. General information

NPI: 1659353100
Provider Name (Legal Business Name): WILLIAM M DEMARCHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9878 CLINT MOORE ROAD SUITE 202
BOCA RATON FL
33496-1037
US

IV. Provider business mailing address

9878 CLINT MOORE ROAD SUITE 202
BOCA RATON FL
33496-1037
US

V. Phone/Fax

Practice location:
  • Phone: 561-451-2454
  • Fax: 561-451-1223
Mailing address:
  • Phone: 561-451-2454
  • Fax: 561-451-1223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME0073867
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME73867
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: