Provider Demographics
NPI:1851333975
Name:DEMORIZI, NESTOR M (MD)
Entity Type:Individual
Prefix:
First Name:NESTOR
Middle Name:M
Last Name:DEMORIZI
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 1:8500 SW 92ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7379
Mailing Address - Country:US
Mailing Address - Phone:305-279-3878
Mailing Address - Fax:786-235-0384
Practice Address - Street 1:8500 SW 92ND ST STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7379
Practice Address - Country:US
Practice Address - Phone:305-279-3878
Practice Address - Fax:786-235-0384
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME44437207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96629UMedicare PIN
D63923Medicare UPIN