Provider Demographics
NPI:1033359658
Name:DEMASI, MONICA A (LAC, LMT, AP, DOM)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:A
Last Name:DEMASI
Suffix:
Gender:F
Credentials:LAC, LMT, AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11051 NW 11TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-7830
Mailing Address - Country:US
Mailing Address - Phone:516-304-8078
Mailing Address - Fax:
Practice Address - Street 1:2741 EXECUTIVE PARK DR STE 4
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3641
Practice Address - Country:US
Practice Address - Phone:954-900-9708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003995-1171100000X
FL61183225700000X
FL2752171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty