Organization Active NPI

Demac Healthcare LLC

  • Psychiatry Physician
  • Longwood, FL
National Provider Identifier
1104658103
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DEMAC HEALTHCARE LLC
Practice address
2917 W State Road 434 Ste 111
Longwood, FL 32779-4884
Phone
(407) 741-3690
NPI assigned
Aug 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erica Tilus, PMHNP-BCNPI 1982355178
Title
Owner
Phone
(407) 844-9440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

2917 W State Road 434 Ste 111
Longwood, FL 32779-4884

Mailing address

1970 E Osceola Pkwy Ste 338
Kissimmee, FL 34743-8629
Phone (407) 741-3690

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741392000000",
    "number": "1104658103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 E OSCEOLA PKWY STE 338",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347438629",
            "telephone_number": "407-741-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 W STATE ROAD 434 STE 111",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794884",
            "telephone_number": "407-741-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMAC HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-17",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A",
        "authorized_official_last_name": "TILUS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-844-9440",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.