Provider Demographics
NPI:1376538546
Name:DEMASI, CLEMENT (MD)
Entity Type:Individual
Prefix:DR
First Name:CLEMENT
Middle Name:
Last Name:DEMASI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 SCENIC DR
Mailing Address - Street 2:SENIOR FRIENDSHIP CENTERS, INC.
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1510
Mailing Address - Country:US
Mailing Address - Phone:941-584-0043
Mailing Address - Fax:941-496-8627
Practice Address - Street 1:2350 SCENIC DR
Practice Address - Street 2:SENIOR FRIENDSHIP CENTERS, INC.
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1510
Practice Address - Country:US
Practice Address - Phone:941-584-0043
Practice Address - Fax:941-496-8627
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLLL612207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56864Medicare UPIN
FL58168YMedicare ID - Type Unspecified