Provider Demographics
NPI:1376592956
Name:DEMERY, FRANK D (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:D
Last Name:DEMERY
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 1:10111 WILSKY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625
Mailing Address - Country:US
Mailing Address - Phone:813-961-2222
Mailing Address - Fax:813-961-2220
Practice Address - Street 1:10111 WILSKY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625
Practice Address - Country:US
Practice Address - Phone:813-961-2222
Practice Address - Fax:813-961-2220
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82542207R00000X, 208000000X
FLME873042080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL456279OtherAETNA-PEDIATRICS
FL916506OtherUSA HEALTH NET
FL267055100Medicaid
FL188446OtherA,MERIGROUP
FL224476OtherWELLCARE
FL224476OtherHEALTHEASE
FL22476OtherSTAYWELL
FL06600OtherUNIVERSAL HEALTH CARE
FL290718OtherAVMED
FL10003701OtherCITRUS HEALTH
FL2107757OtherFIRST HEALTH NETWORK
FL360122OtherAETNA-ADULT
FL5827779OtherCIGNA
FL0410089OtherMEDICARE COMPLETE
FL81200OtherBLUE CROSS/BLUE SHIELD FL
FL224476OtherHEALTHEASE
FL0410089OtherMEDICARE COMPLETE
FL290718OtherAVMED
FL81200AMedicare PIN