Provider Demographics
NPI:1801922927
Name:DEMSHOK, WILLIAM (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:DEMSHOK
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 SW 78TH ST
Mailing Address - Street 2:BIG UNIT C
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5655
Mailing Address - Country:US
Mailing Address - Phone:305-665-8257
Mailing Address - Fax:
Practice Address - Street 1:900 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1119
Practice Address - Country:US
Practice Address - Phone:305-326-6170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 1504363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical