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General NPI Number Information
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NPI Number | 1538127444
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Entity Type | Organization
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Legal Business Name | CLEMENT J DEMASI MD PA
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1203 JACARANDA BLVD
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City | VENICE
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State | FL
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Zip | 34292-4519
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Country | US
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Telephone | 941-492-9756
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Fax | 941-493-8941
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Provider Business Mailing Address
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Address Line | 1203 JACARANDA BLVD
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City | VENICE
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State | FL
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Zip | 34292-4519
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Country | US
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Telephone | 941-492-9756
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Fax | 941-493-8941
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Authorized Official
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Title or Position | VP MANAGED CARE SERVICES
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Name | MS. DEBRA S HUFFMAN
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Credential | MHA
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Telephone | 636-549-2384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME66068
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License Number State | FL
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