Provider Demographics
NPI:1851531172
Name:DEMAAYER, GINA MARRA (ITDS)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARRA
Last Name:DEMAAYER
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10557 CORAL KEY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3461
Mailing Address - Country:US
Mailing Address - Phone:813-907-7170
Mailing Address - Fax:
Practice Address - Street 1:10557 CORAL KEY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3461
Practice Address - Country:US
Practice Address - Phone:813-907-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist