Provider Demographics
NPI:1346023645
Name:DEMING, CASEY NICOLE (DPT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:NICOLE
Last Name:DEMING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 WHITE ISLE LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7896
Mailing Address - Country:US
Mailing Address - Phone:813-765-1445
Mailing Address - Fax:
Practice Address - Street 1:578 OCOEE COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4219
Practice Address - Country:US
Practice Address - Phone:407-656-3061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT405412251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic