Healthcare Provider Details

I. General information

NPI: 1942496633
Provider Name (Legal Business Name): WILLIAM M DEMARCHI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 09/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME73867
License Number StateFL

VIII. Authorized Official

Name: DR. WILLIAM M DEMARCHI
Title or Position: PRESIDENT
Credential: M.D
Phone: 561-451-2454