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General NPI Number Information
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NPI Number | 1477279255
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Entity Type | Individual
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Provider Name | MAYA DEMA APRN
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Gender | Female
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1400 N US HIGHWAY 441 STE 810
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City | LADY LAKE
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State | FL
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Zip | 32159-8987
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Country | US
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Telephone | 352-750-2108
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Fax | 352-750-1836
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 200
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City | MIAMI
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State | FL
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Zip | 33126-3168
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN11022390
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License Number State | FL
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