Healthcare Provider Details

I. General information

NPI: 1922747542
Provider Name (Legal Business Name): JOANNA DEMBEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-4717
US

IV. Provider business mailing address

PO BOX 100237
GAINESVILLE FL
32610-0237
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5159
  • Fax: 352-273-5213
Mailing address:
  • Phone: 352-273-5159
  • Fax: 352-273-5213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME168711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: