Healthcare Provider Details

I. General information

NPI: 1609606573
Provider Name (Legal Business Name): ECE DEMIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 SE OCEAN BLVD
STUART FL
34994-2573
US

IV. Provider business mailing address

2310 GRIFFON RD UNIT 305
VERO BEACH FL
32966-2577
US

V. Phone/Fax

Practice location:
  • Phone: 772-276-7242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119502
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: