Healthcare Provider Details

I. General information

NPI: 1427217140
Provider Name (Legal Business Name): DEMETRIOS GASPARIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 GOODLETTE-FRANK RD N STE 202
NAPLES FL
34103-4595
US

IV. Provider business mailing address

2450 GOODLETTE-FRANK RD N STE 202
NAPLES FL
34103-4595
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-0222
  • Fax: 239-624-6121
Mailing address:
  • Phone: 239-624-0222
  • Fax: 236-624-6121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME179633
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: