Provider Demographics
NPI:1407536477
Name:DEMASCIO, RAYMOND ANTHONY (FNP, APRN-C)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:ANTHONY
Last Name:DEMASCIO
Suffix:
Gender:M
Credentials:FNP, APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9457 SE 163RD ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-5895
Mailing Address - Country:US
Mailing Address - Phone:352-272-5764
Mailing Address - Fax:
Practice Address - Street 1:9457 SE 163RD ST
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-5895
Practice Address - Country:US
Practice Address - Phone:352-272-5764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily