Provider Demographics
NPI:1508490764
Name:DEMCHAK, DELIA
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:
Last Name:DEMCHAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 KYOTO GARDENS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2799
Mailing Address - Country:US
Mailing Address - Phone:561-931-1470
Mailing Address - Fax:
Practice Address - Street 1:3507 KYOTO GARDENS DR STE 110
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2799
Practice Address - Country:US
Practice Address - Phone:561-931-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235999376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker