Provider Demographics
NPI:1093243495
Name:DECHMEROWSKI, JOHN WILLIAM
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:DECHMEROWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E MONUMENT AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5761
Mailing Address - Country:US
Mailing Address - Phone:407-847-2901
Mailing Address - Fax:
Practice Address - Street 1:2445 S HWY 27
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6876
Practice Address - Country:US
Practice Address - Phone:352-404-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS1566237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist