Healthcare Provider Details

I. General information

NPI: 1245770130
Provider Name (Legal Business Name): CAITLYN DEMING ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N MILITARY TRL SUITE 245
BOCA RATON FL
33431-6365
US

IV. Provider business mailing address

300 VIA LUGANO CIR APT 204
BOYNTON BEACH FL
33436-7161
US

V. Phone/Fax

Practice location:
  • Phone: 561-994-2007
  • Fax:
Mailing address:
  • Phone: 561-291-4218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9361429
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: