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NPI Code Detail

MEDICARE: ARTEMIS DEMETRA XENICK MT-BC

MEDICARE: ARTEMIS DEMETRA XENICK MT-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171W00000XContractor19324FL
2225A00000XMusic Therapist19324FL

General Provider Information

NPI Number : 1134095847
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARTEMIS DEMETRA XENICK MT-BC
Provider Business Mailing Address
First Line : 3003 RICHVIEW PARK CIR S
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32301-3413
Country : US
Telephone Number : 813-367-7308
Fax Number :
Provider Business Practice Location Address
First Line : 1700 N MERIDIAN RD
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32303-5646
Country : US
Telephone Number : 229-400-0722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2025
Last Update Date : 10/16/2025

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Directions to “ ARTEMIS DEMETRA XENICK MT-BC” Practice Location

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